Understanding Facet Joint Arthritis
Facet joint arthritis is a common cause of neck and back pain that develops when the small joints along the back of the spine begin to wear down and become irritated.
What Is Facet Joint Arthritis?
Facet joints are small joints located along the back of the spine. They connect neighboring vertebrae and help guide and stabilize movement as you bend, twist, and move.
Like many other joints in the body, facet joints contain cartilage that allows the joint surfaces to move smoothly against one another. Over time, this cartilage may gradually wear down.
When this happens, the joint can become irritated, stiff, and painful. This condition is often referred to as facet joint arthritis, facet arthropathy, or facet joint osteoarthritis.
A Common Finding
Facet joint changes become increasingly common with age, but arthritis seen on imaging does not always mean the joint is causing pain.
How Facet Joint Arthritis Develops
Facet joints experience movement and mechanical stress every day. Over time, changes within these joints may lead to inflammation, stiffness, and pain.
Cartilage Changes
The smooth cartilage covering the joint surfaces may gradually thin or wear down.
Joint Irritation
Changes within the joint may increase friction and contribute to irritation or inflammation.
Stiffness
The affected joints may become less flexible, making certain movements uncomfortable.
Pain
An irritated facet joint may become a source of localized or referred neck or back pain.
What Does Facet Joint Arthritis Feel Like?
Facet joint arthritis commonly causes an aching or stiff feeling in the neck or back. Some people notice more stiffness after sleeping or after remaining in one position for an extended period of time.
Certain movements may also increase symptoms. Pain can sometimes become more noticeable when standing, twisting, or bending the spine backward.
Depending on which facet joints are involved, discomfort may also be felt in nearby areas rather than directly over the affected joint.
Where Can Facet Joint Pain Be Felt?
Symptoms depend partly on which area of the spine is affected. Facet joint pain may remain localized or be referred into nearby areas.
Cervical Facet Joints
Facet arthritis in the neck may cause neck stiffness and pain that can sometimes be felt around the shoulders, upper back, or back of the head.
Lumbar Facet Joints
Facet arthritis in the lower back may cause localized back pain or discomfort that can sometimes be felt around the buttocks, hips, or upper thighs.
Is the Facet Joint Really Causing the Pain?
Arthritis and other age-related changes are commonly visible on spinal imaging. The important question is whether those changes are actually responsible for your symptoms.
Detailed pain history
Physical examination
Movement and positioning tests
Review of X-rays, MRI, or other imaging
Evaluation of other possible pain sources
Diagnostic injections when appropriate
In certain cases, targeted diagnostic injections may help determine whether a particular facet joint or the nerves associated with it are contributing to your pain.
How Is Facet Joint Arthritis Treated?
Treatment depends on the severity of your symptoms, how long they have been present, and how much they interfere with your movement and daily activities.
Exercise & Physical Therapy
Stretching, strengthening, and improving movement may help reduce stiffness and improve support for the spine.
Medication
Over-the-counter or other medications may be recommended to help manage pain and inflammation when appropriate.
Targeted Injections
In selected patients, injections may help diagnose the source of pain or provide temporary relief.
Additional Procedures
If conservative care does not provide enough relief, additional minimally invasive treatment options may be considered based on the diagnosis.
A Proper Diagnosis Comes First
Facet arthritis is common, especially as we age, but an arthritic joint seen on imaging is not automatically the source of your pain. Utah Spine & Pain evaluates your symptoms, physical examination, and diagnostic findings together to determine whether the facet joints may be contributing to your discomfort and which treatment options may be appropriate.
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