The facet joint is a crucial anatomic region of the spine owing to its biomechanical role
in facilitating articulation of the vertebrae of the spinal column. It is a diarthrodial joint
with opposing articular cartilage surfaces that provide a low friction environment and a
ligamentous capsule that encloses the joint space. Together with the disc, the bilateral
facet joints transfer loads and guide and constrain motions in the spine due to their geometry
and mechanical function. Although a great deal of research has focused on defining
the biomechanics of the spine and the form and function of the disc, the facet joint
has only recently become the focus of experimental, computational and clinical studies.
This mechanical behavior ensures the normal health and function of the spine during
physiologic loading but can also lead to its dysfunction when the tissues of the facet joint
are altered either by injury, degeneration or as a result of surgical modification of the
spine. The anatomical, biomechanical and physiological characteristics of the facet joints
in the cervical and lumbar spines have become the focus of increased attention recently
with the advent of surgical procedures of the spine, such as disc repair and replacement,
which may impact facet responses. Accordingly, this review summarizes the relevant
anatomy and biomechanics of the facet joint and the individual tissues that comprise it.
In order to better understand the physiological implications of tissue loading in all conditions,
a review of mechanotransduction pathways in the cartilage, ligament and bone is
also presented ranging from the tissue-level scale to cellular modifications. With this context,
experimental studies are summarized as they relate to the most common modifications
that alter the biomechanics and health of the spine—injury and degeneration. In
addition, many computational and finite element models have been developed that enable
more-detailed and specific investigations of the facet joint and its tissues than are provided
by experimental approaches and also that expand their utility for the field of biomechanics.
These are also reviewed to provide a more complete summary of the current
knowledge of facet joint mechanics. Overall, the goal of this review is to present a comprehensive
review of the breadth and depth of knowledge regarding the mechanical and
adaptive responses of the facet joint and its tissues across a variety of relevant size
scales.
Fig. 2 Schematic drawings of the facet joint and the primary tissues that compose it, as
well as the cartilage and menisci of the facet articulation. The blowup illustrates the different
zones of the articular cartilage layer with the collagen fibers and chondrocytes orientations
through its depth. A cut through of the facet joint (A-A) is also drawn to show the
elliptically-shaped inter-articular surfaces with the cartilage surface on the inferior facet,
the synovium, and meniscoids. Adapted collectively from Martin et al., 1998, Pierce et al.,
2009, and Bogduk and Engel, 1984 [
Facet Joint Injury Theories:
Both theories may cause pain and reflex muscle spasms
Entrapment Theory:
Joint meniscoid becomes trapped within the joint
Extrapment Theory:
Joint meniscoid becomes trapped within the
subcapsular space, pinched between the capsule and
bony lip
Scientifically based modern homeopathic products, such as Traumeel, provide a safe and efficient alternative to avoid the side effects of many drugs for the treatment of symptoms such as injuries, pain, sleeplessness, muscle cramping, allergies, sinuses, and many more. Stimulate your body's own natural defense with gentle, yet effective medications.
Indications:
Injuries of all kinds (sports, accidents) such as sprains, dislocations, contusions, burns, effusions of blood and effusions into a joint, fractures etc; post-operative and post-traumatic edema and swelling of the soft tissues; inflammatory processes and degenerative processes associated with inflammation on the various organs and tissues, including, in particular, on the support and mobility apparatus (tendovaginitis, styloiditis, epicondylitis, bursitis scapulohumeral periarthritis, arthrosis of the hip, knee and small joints); parodontitis, suppuration of the gingival pockets, paradontosis, commotio cerebri.
TRAUMEEL ® is an anti-inflammatory, analgesic, anti-edematous, anti-exudative combination formulation of 12 botanical and 2 mineral substances. TRAUMEEL ® is officially classified as a homeopathic combination remedy. It is indicated for the temporary relief of symptoms associated with inflammatory, exudative, and degenerative processes due to acute trauma (such as contusions, lacerations, fractures, sprains, post-operative wounds, etc.), repetitive or overuse injuries (such as tendinitis, bursitis, epicondylitis, etc.), and for the temporary relief of minor aches and pains associated with such conditions. TRAUMEEL ® is also indicated for the temporary relief of minor aches and pains associated with backache, muscular aches, and the minor pain from rheumatoid arthritis, osteoarthritis, gouty arthritis, and ankylosing spondylitis.
TRAUMEEL ® can be used to treat elderly arthritic patients who cannot tolerate the GI side effects associated with the conventional NSAIDs or for patients on anticoagulant medication.
Ointment: - 100 g cont.:
Arnica 3X 4.416 g ; Calendula 1X, Hamamelis 1X ana 1.326 g ; Echinacea angustifolia 1X ; Echinacea purpurea 1X ; Chamomilla 1X ana 0.442 g ;
Symphytum 1X ; Bellis perennis 1X ; Hypericum 3X ; Millefolium 1X ana 0.265 g; Aconitum 3X Belladonna 3X ana 0.147 g ; Mercurius solubilis Hahnemanni 6X 0.118 g; Hepar sulfuris 6X 0.074 g.
Pharmacological and clinical notes
Constituents Indication
Arnica (mountain arnica) - To stimulate the healing of wounds, fractures, dislocations, contusions, hematomas, myocardial weakness, neuralgia, myalgia, analgesic, hemostatic
Calendula la (calendula) - Slowly healing wounds, promotes granulation, analgesic
Suppurations, abscesses, gingivitis, stomatitis, nasopharangeal catarrh, catarrh of the sinuses, cholangitis, shrinking action on edematous conditions
Hepar sulfuris (calcium sulphide) - Tendency to suppuration, especially on the skin and Iymph glands (furuncles, pyodermia, panaris, phlegmons), tonsillar abscesses, chalazions, hordeolums, hemicrania, urinary disorders, hypersensitivity to cold and draughts
Chamomilla (chamomile) – Anti-iflammatory; stimulates granulation, promotes healing in difficultly healing wounds and ulcers; fistulae, hemorrhoids, mastitis, intertrigo, aphthous stomatitis, conditions of restlessness and excitation, disorders of dentition, otitis media, glandular swellings
Symphytum (comfrey) - To accelerate callus formation in fractures; periostitis, causalgia, disorders arising from amputation stumps; contusions
Bellis perennis (daisy) - Dislocations, contusions, sensation of soreness in the abdominal wall/cavity, exudative processes, resorption of edema
Echinacea angustifolia (narrow leaved cone flower) - Increase in the mesenchymal defenses; inflammation of all kinds and locations, septic processes; hyaluronidase inhibiting, anti-iflammatory action
Echinacea purpurea (purple cone flower) - Activation of the histogenous and hematogenous defenses in inflammatory processes and general infections, fibroblast-stimulating effect
Hypericum (St. John's wort) - Neural and cerebral injuries, e.g. commotio cerebri; neural pains upon or after injuries; hemostatic
The mechanism of action of Traumeel arises from a combination effect (Burgi) of vegetable and inorganic chemical factors, which are characterized by the following properties:
1. Anti-inflammatory and antiviral action of mercurials
2. Improvement of the vasotonia (Aconitum, Arnica), rendering the vessels impervious (action of calcium) Elimination of venous stasis and antithrombotic effect (Hamamelis) as well as hemostasis (Millefolium), together, with normalization of the prothrombin level
3. Support and improvement of the cellular respiration and oxidation process by means of calcium sulphide and polysulphide (hepar sulfuris)
4. Stimulation of the main defense system
5. Stimulation of wound healing and shock control by means of phytotherapeutic agents
(Arnica, Calendula, Echinacea, Symphytum); formation of "pus bonum et laudabile" (good and commendable pus)
2. Anti-exudative : Swelling of the soft tissues, traumatic, post-operative, commotio cerebri, arthrosis (with and without irritating discharge), effusions into a joint spontaneous, traumatic, post-operative; hematomas in the joints (traumatic hemarthrosis), hematomas in the soft tissues, tendovaginitis, bursitis praepatellaris,otitis media
Dosage Ointment: Apply to the affected parts and rub in, morning and evening,
or if necessary, more often, possibly also applying an ointment dressing.
Warning : In rare cases, hypersensitivity to one or more ingredients may result in allergic skin reactions.
Contraindications: Hypersensitivity to Traumeel or any of its ingredients.
For external use only. Do not apply over large areas of the body. If symptoms persist or worsen, or if a rash develops, a physician should be consulted. Store at room temperature. Keep this and all medicines out of the reach of children.
