Which test helps identify facet joint–related pain?

Which test helps identify facet joint–related pain?

• A. Straight leg raise
• B. Provocative facet joint tests (facet loading test)
• C. Spurling test
• D. Tinel sign

Answer: (B)

The test focuses on identifying facet joint–related pain by specifically loading the facet joints to provoke a painful response. Provocative facet joint tests, also called facet loading tests, place stress on the facet joints through movements like extension combined with rotation or targeted axial loading. If this loading reproduces the patient’s familiar, localized axial pain, it suggests facet joints as the source. This targeted approach is why it’s the best choice for detecting facet-mediated pain. In contrast, the straight leg raise primarily provokes nerve root irritation or sciatica by tensioning the neural structures, not the joints. The Spurling test also targets cervical nerve root compression rather than facet joints, and the Tinel sign assesses peripheral nerve irritation at a nerve distribution. These tests help identify neural or peripheral nerve issues rather than facet joint pain, making them less specific for facet-related sources.

The test focuses on identifying facet joint–related pain by specifically loading the facet joints to provoke a painful response. Provocative facet joint tests, also called facet loading tests, place stress on the facet joints through movements like extension combined with rotation or targeted axial loading. If this loading reproduces the patient’s familiar, localized axial pain, it suggests facet joints as the source. This targeted approach is why it’s the best choice for detecting facet-mediated pain.

In contrast, the straight leg raise primarily provokes nerve root irritation or sciatica by tensioning the neural structures, not the joints. The Spurling test also targets cervical nerve root compression rather than facet joints, and the Tinel sign assesses peripheral nerve irritation at a nerve distribution. These tests help identify neural or peripheral nerve issues rather than facet joint pain, making them less specific for facet-related sources.