1. Running head: ATERNATIVE THERAPIES FOR THE RELIEF OF FACET JOINT PAIN 1
Alternative Therapies for the Relief of Facet Joint Pain
David Commini
Everglades University

2. ALTERNATIVE THERAPIES FOR THE RELIEF OF FACET JOINT PAIN 2
Abstract
This paper examines a few alternative therapies for the treatment and relief of facet joint pain.
In addition to the alternative therapies, traditional therapies are also examined. Traditional therapies
will include medications, physical therapy, and surgery. Alternative therapies will include chiropractic,
herbal/botanical medicines, and aromatherapy.

3. ALTERNATIVE THERAPIES FOR THE RELIEF OF FACET JOINT PAIN 3
Alternative Therapies for the Relief of Facet Joint Pain
Facet joint disorders are among the most common recurring lower back problems (Ray, 2002).
Symptoms include intermittent lumbar facet pain, tenderness over inflamed facet joints, discomfort
whilst leaning backwards, and pain radiating from the facets into the buttocks and into the upper leg
(Ray, 2002). For lumbar pain, “standing may be somewhat limited but sitting and riding in a car is the
worst. So-called "limited duty" (sitting) assignments for patients with low back pain are paradoxically
bad. When at its height of pain and disability, the muscle spasm is so continual that it fatigues the
muscles, which in turn, repeats the cycle.” (Ray, 2002)
Traditional medical treatments for facet joint disorders will often include Physical Therapy,
steroid shots, or even nerve blocking surgery, in conjunction with NSAIDs for general pain relief. In
the case of physical therapy, the therapist may have the patient do a series of exercises that will help
strengthen the core and back muscles. Even though movement may be limited, staying stationary is the
least helpful thing to be done when dealing with facet joint pain.
Epidural steroid shots seem to be popular amongst many doctors and pain management
specialists, given in a series of three or four shots a year if needed (Scott, 2013). Results can vary from
no relief to full relief of pain. The cost of such a procedure can range between $200 and $300 each
(Scott, 2013). Epidural steroid shots are not without risk as a fungal meningitis outbreak occurred in
2012 from a tainted steroid batch - 58 people died (Scott, 2013). The author would like to note that he
had two epidural steroid shots spaced out over a few months and saw little to no relief from his pain
either time, though environmental factors could have been in play during that time.
Chiropractic treatments may improve range of motion, relax the muscles, and even reduce pain;
however there is no evidence of chiropractic treatments stopping facet join pain (caused by
osteoarthritis) completely (Ehrlic, 2014). Reviewing scientific literature suggests that, “chiropractic,

4. ALTERNATIVE THERAPIES FOR THE RELIEF OF FACET JOINT PAIN 4
especially when combined with glucosamine supplements and stretches and exercise, helps treat OA.
Chiropractors will avoid using direct thrusts or pressure on red, swollen joints.” (Ehrlic, 2014)
Treatment for facet joint pain can be done while also treating decompression flexion distraction (Kline,
2006).
Price for chiropractic treatments can range from around $34 to just over $100 with an average
price of $65 ("How Much Does a Chiropractor Cost?”). Of course, if there are any other treatments
needed, such as massage, the price can go up. While some insurance may cover chiropractic care, some
may not and the patient would be left covering the cost of multiple sessions. While chiropractic
treatments could be more beneficial in pain management than the previously mentioned epidural
steroids the out of pocket cost can quickly make this treatment not as cost effective.
Boswellia, or more commonly known as Frankincense, has been shown to reduce pain and
inflammation. As opposed to NSAIDs there are no known side effects. One study's findings showed,
“that there is statistically significant improvement in the efficacy variables in the patients of
OA knee treated with BSE. After eight weeks of thrice daily administration in the dose of 333
mg per capsule, BSE decreased the pain in the affected knee joints, decreased the swelling and
improved the loss of function in terms of increased knee flexion, stairs climbing and walking
distance. Radiologically there was no change in the affected joints. BSE is recommended in the
patients with OA knee and may also have therapeutic utility in the treatment of other arthritis
like osteoarthritis of other joints, JRA, rheumatoid arthritis, ankylosing spondylosis and
degenerative diseases of spine (Kimmatkar, 2003).”
Basically the study says that Boswellia is more effective at pain relief than NSAIDs. Cost wise
can vary. Swansonvitamins.com has Boswellia 100 400mg capsules listed at $3.99, as compared to
Walmart having BC Powder 50 count listed at $6.22 and Equate Naproxen 100 count listed at $5.48.

5. ALTERNATIVE THERAPIES FOR THE RELIEF OF FACET JOINT PAIN 5
Not only is the Boswellia better at providing relief, it is also much more cost effective than treating
with NSAIDs or any of the other previously mentioned treatments.
As well as taking an herbal supplement, a sufferer from facet joint pain could also use essential
oils through the guidance of an experienced aromatherapist. The effects would be the same as what was
shown in the study quoted above. Of course the author can not stress the importance of having the
guidance of an experienced aromatherapist enough, since many people who sell essential oils via multi-
level marketing schemes can often be very misleading to make a sell.
The cost of Boswellia oils can range from $20 to $96 for a 1/2oz bottle, depending on where
one purchases the oil from (the author wants to note that the two most expensive oils he found were
from aforementioned multi-level marketing schemes). If a sufferer of facet joint pain does purchase
Boswellia oil for pain relief this could still be more cost effective that NSAIDs in the long run since the
oil would often be diluted before being applied to the skin, thus allowing for the oil to last longer,
though the outright cost can be very steep. Oils can often be more potent than regular herbal
supplements, side effects can include, “when taken orally include abdominal pain, bloating, diarrhea,
nausea, stomach pain, vomiting and a burning sensation in the stomach. The side effects of
frankincense oil creams include a rash, redness, itching and increased skin sensitivity. The side effects
typically occur at the application site (Davies, 2009)." It was unclear to the author if the side effects
were from the oil itself or possibly other ingredients in the skin creams interacting with the oil, though
in the previously cited study and other sources throughout the internet state that there are no known
interactions between Boswellia and other medications.
In conclusion, it seems that supervised excersises done by a Physical Therapist (Ehrlic, 2014)
could be the most beneficial for improved function since it doesn't inlvove medication and would most
likely be paid for by insurance. However, getting to the point of doing exercises one may need to take a

6. ALTERNATIVE THERAPIES FOR THE RELIEF OF FACET JOINT PAIN 6
medication of some sort, it seems that taking Boswellia as an herbal supplement would then be most
beneficial overall. The author would not recommend going the oil of Boswellia route – despite being
very effective - since the oil can be quite expensive.

7. ALTERNATIVE THERAPIES FOR THE RELIEF OF FACET JOINT PAIN 7
References:
Davies, D. (2009, December 31). Side Effects of Frankincense Oil. Retrieved July 19, 2015.
Ehrlic, S. (2014, January 21). Osteoarthritis. Retrieved July 22, 2015, from
http://umm.edu/health/medical/altmed/condition/osteoarthritis
How Much Does a Chiropractor Cost? - CostHelper.com. (n.d.). Retrieved July 19, 2015.
Kimmatkar N, Thawani V, Hingorani L, Khiyani R. Efficacy and tolerability of Boswellia serrata
extract in treatment of osteoarthritis of knee – A randomized double blind placebo controlled
trial. Phytomedicine [serial online]. January 1, 2003;10:3-7. Available from: ScienceDirect,
Ipswich, MA. Accessed July 19, 2015.
Kline, C. (2006, February 1). Track Record. Retrieved July 19, 2015, from
http://www.acatoday.org/JacaDisplay1.cfm?CID=1214&DisType=PDF
Ray, C. (2002, December 20). Symptoms and Diagnosis of Facet Joint Problems. Retrieved July 20,
2015, from http://www.spine-health.com/conditions/arthritis/symptoms-and-diagnosis-facet-
joint-problems
Scott, J. (3012, June 24). Do Steroid Shots Really Alleviate Back Pain? Retrieved July 20, 2015.