Cervical spinal facet joint injuries are a common problem with many people and are usually associated in a traumatic event, although a traumatic event is not a prerequisite. These types of injuries can be very painful at times and can turn into a chronic situation. The facet joints of the cervical spinal are very important in normal biomechanics of the neck, if they are not moving properly one will feel pain and have a limited range of motion. More in depth the facet joints guide motion in the flexion, extension, lateral flexion and rotational planes. They are also important in axial loading, which means loading from the top of the head. The facet joints are orientated at certain angles which facilitate motion with their responsive area in the spine. Since the cervical spine moves in a fluid motion if just one cervical facet joint is misaligned or inflated globe range of motion will be hampered.
During the tragic event the head is flung in a flexion and extension plane (forward and back), when this is done at a very rapid pace it can cause a litany of problems in regard to injuries. First the motion that is accentuated will cause a bruising of the cartilage and subdural bone, which will then in turn cause inflammation or pain. Other problems that could arise would be stretching of the joint capsule, disc herniations, and pulling of nerves or neural sensitive tissues in the joint space. All of these injures are going to start the cascade of the infection process which will focus on cleaning up the injured tissue but will also be felt as pain. The inflammation and pain is going to hinder normal range of motion, in turn muscle spasms are going to manifest due to the inflammation process but also to extreme motion during the traumatic event. The muscles get very tight due to a process called muscle guarding in which the muscle wants to protect the injured area as much as possible so they tighten to prevent further injuries.
The management of these cases employed by the chiropractor is done in a process of steps. During first evaluation the patient is usually to acute to do many different types of therapies. Usually therapy should involve decreasing inflammation and spasmodic muscles in the cervical spine. This can be achieved conservatively by using a series of cryotherapy (ice treatments) to help with the pain. Electric muscle stimulation and gentle stretching can be employee to again decrease pain and facilitate some range of motion. Once there is some reduction of inflammation, pain, and muscle spasms the mobilization phase can be ushered in, as the patient progresses they can have full chiropractic adjustments which are extremely beneficial to restoring normal cervical function. The last step is to strengthen and stabilize the area by doing range motion exercises which can then progress to resisted exercises.
I must stress the rehabilitation of this injury is paramount, if pain management is done in the form of medicine, while it may help with the pain, the function of the spine will never be the same and the longer one goes without rehabilitation the long it will take to restore normal function if ever at all.