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Facet Joint Syndrome

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Facet Joint Syndrome

Facet joints are an essential part of your spine’s structure, allowing you to twist, turn, bend and move. Located between the adjacent vertebrae of the spine, these joints are in constant motion and provide your spine with stability and flexibility. A common cause of lower back and lumbar pain is facet joint arthropathy, also known as facet joint syndrome. If you struggle with back pain, this condition could be the cause. 

At Desert Institute for Spine Care in Arizona, we specialize in treating patients with facet joint pain. With accurate diagnosis and a wide array of treatment plans, we can help treat the area causing your discomfort.

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A facet joint highlighted on a model of the human spine.
Facet joint in a human spine model, highlighted in red where there is pain from facet joint syndrome.

What Is Facet Arthropathy?

Facet joints are small joints that connect the adjacent vertebrae running the length of your spine. Each one is lined with smooth, flexible cartilage and cushioned by synovial fluid, allowing your spine to turn and bend with minimal friction.

Like other joints, facet joints can degenerate over time. This degeneration, known as facet arthropathy or facet arthrosis, is a form of arthritis. 

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What Causes Facet Arthrosis?

When cartilage starts to break down, the bones begin to rub directly against each other. This friction triggers inflammation and can produce bony growths, called bone spurs. These bone growths can contribute to inflammation and, in some cases, may press on nearby nerves and intensify pain.

Facet degenerative arthropathy can develop in the neck, mid-back or lower back. It most often affects the neck and lower back, since these regions handle the greatest range of motion and load.

Understanding what causes this degeneration can help you determine whether you’re at risk.

Risk Factors for Facet Arthrosis

While anyone can develop facet arthropathy, several factors can significantly accelerate joint degeneration. These include:

  • Age: People over 45 face a higher risk. As the body ages, cartilage cushioning gradually wears down, increasing friction and triggering inflammation. One study found that lumbar facet joint osteoarthritis became more common with age, affecting 68.4% of adults ages 50 to 59 and more than 85% of adults ages 60 and older in the study population.
  • Degenerative disc disease: As spinal discs become brittle and thin over time, more pressure shifts onto the facet joints. This accelerates the gradual breakdown of the surrounding structures.
  • Weight above a healthy range: A body mass index over 25 is a risk factor. Added weight places extra mechanical pressure on these small joints with every step, bend and movement you make.
  • Trauma: Sudden injuries, such as falls, car accidents or sports impacts, can wear down these small joints.
  • Repeated movements: Lifting something heavy or bending over can gradually overload the facet joints. This is especially common in jobs that demand these motions day after day.

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Symptoms of Facet Joint Syndrome

Symptoms vary depending on the region of the spine affected. Facet degenerative arthropathy in the neck may cause pain in the shoulders or trigger headaches at the lower back of the head. When it develops in the mid-back, you might feel pain in the chest or abdomen. In the lower back, pain is often localized, but it may also radiate downward into the hip or thigh.

Beyond these regional pain patterns, this condition often produces other telltale symptoms. These might include:

  • Morning stiffness that eases as you move throughout the day
  • Pain that worsens with extension and rotation
  • Muscle spasms near the affected joints
  • Limited range of motion in the neck or back
  • A popping or grinding sensation during movement

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A woman holding her back in pain.
Dr. Wang Explaining Spine Condition to Patient

Facet Joint Syndrome Diagnosis

Imaging alone, including X-rays, MRIs and CT scans, cannot confirm facet arthropathy as the origin of your pain. Many people with visible degeneration on imaging have no symptoms at all. Conversely, others with significant pain show little visible change on a scan.

Diagnosis typically follows a specific pathway. Surgeons will review your health records and conduct a thorough physical exam, then move to imaging to help rule out other potential causes.

If facet joint syndrome still seems likely, they’ll often recommend a diagnostic nerve block. This is a targeted injection that temporarily blocks pain signals, helping confirm if the facet joints are truly the cause before your treatment begins.

At Desert Institute for Spine Care, this process is built into Personalized Pain Mapping, our proprietary diagnostic technique. During a Personalized Pain Mapping consultation, our surgeons combine your symptom history, a thorough physical examination and diagnostic testing to help pinpoint the exact root of your pain. Once we’ve established the underlying cause, we can recommend a treatment path tailored to your specific condition.

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When to See a Professional

It’s best to see a professional when back pain doesn’t improve with rest, over-the-counter pain relievers or basic self-care. If your provider determines that you need treatment, they will usually prescribe conservative care. Many find meaningful relief without ever needing surgery. Conservative options include:

  • Physical therapy
  • Activity modification 
  • Heat and cold therapy 
  • Pain medication 
  • Muscle relaxers 

If these options aren’t enough and your symptoms persist for three to six months or longer, your provider may prescribe an epidural steroid injection or a medial branch diagnostic injection. These injections can offer meaningful pain relief and often help pinpoint the exact source of a patient’s back pain.

Desert Institute for Spine Care might also recommend a long-term surgical option called endoscopic rhizotomy. This technique has offered long-lasting pain relief for many patients.

Why Consider Endoscopic Rhizotomy for Facet Degenerative Arthropathy?

Endoscopic medial branch nerve transection is one of the least invasive procedures available for relieving pain linked to the facet joints. Surgeons use the smallest incision in spine surgery. Since it’s performed on an outpatient basis, you can typically go home the same day.

This technique was invented and developed at DISC. Patients report a 90% success rate, with pain relief lasting up to five years.

Scheduling a Personalized Pain Mapping consultation can help you get the treatment you need, whether that is through conservative care or surgery. 

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Schedule a Consultation at Desert Institute for Spine Care

Living with neck, mid-back or lower back pain can affect every part of your day, from your mood to your ability to stay active. If facet joint syndrome sounds familiar, you don’t have to face it alone or guess at the next step. A Personalized Pain Mapping consultation can identify exactly which facet joints are generating your pain. With a clear target, your care team can create a personalized treatment plan designed to help reduce pain and improve comfort, mobility and function.

At Desert Institute for Spine Care, our board-certified, fellowship-trained surgeons graduated in the top 1% of their programs and bring that same precision to every diagnosis and treatment plan.

Schedule a consultation today at Desert Institute for Spine Care. We are ready to help you reduce back pain and improve your quality of life.

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ENJOY LIFE AGAIN!

Our spine health blog features up-to-date spine education and expert spine tips from our spine specialists here at DISC.

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