Fig. 1. Referred pain pattern from the facet joints. (A) Cervical facet joint syndrome. It is quite difficult to differentiate referral patterns to the greater occipital protuberance from the atlanto-occipital joints and atlanto-axial joints. One of the most common referral pain patterns to the supraspinatus and infraspinatus area with interscapular area originates from the C5-C6 and C6-C7 facet joints, respectively. These facet joints become the common targets of neck straightening. (B) Thoracic facet joint syndrome. Mid-back pain with referred pain to the chest and abdomen arises from senile kyphosis, a long-term sleeping with a semi-Fowler position with the head of the bed at 30°–45° due to respiratory difficulty or intractable abdominal pain, or osteoporotic or osteolytic compression vertebral fractures. (C) Lumbar facet joint syndrome. Referral pain patterns from the upper and lower lumbar facet joints are shown to the groins and buttocks, respectively. It occurs commonly after fusion surgery as junctional pain syndrome.
© Korean J Pain
