Facet Joint Pain: A Common but Overlooked Source of Back Pain

Back pain is one of the most common medical complaints, affecting millions of people each year. While many individuals assume their discomfort stems from muscle strain, herniated discs, or poor posture, another frequent cause often goes unnoticed: facet joint pain. These small joints in the spine play a major role in movement and stability, and when they become irritated or damaged, they can lead to significant and persistent pain. Understanding facet joint pain can help patients seek proper diagnosis and effective treatment.

What Are Facet Joints?

Facet joints are small joints located between each vertebra in the spine. Every spinal level contains two facet joints—one on each side—that connect the vertebrae and allow the spine to bend, twist, and move smoothly. These joints are lined with cartilage and surrounded by a capsule filled with lubricating fluid, similar to other joints throughout the body, such as the knees or shoulders.

Facet joints also help stabilize the spine by controlling excessive motion. However, like any joint, they are susceptible to wear and tear, inflammation, and injury over time.

What Causes Facet Joint Pain?

Facet joint pain typically develops due to degeneration or damage to the joint surfaces. Several factors can contribute to this condition, including:

Age-Related Degeneration

As individuals age, cartilage within the facet joints can gradually wear down. This process, often referred to as spinal arthritis or osteoarthritis, reduces the protective cushioning within the joints, leading to inflammation and pain.

Repetitive Stress and Overuse

Jobs or activities that involve repeated bending, twisting, or heavy lifting can place excessive strain on the facet joints. Over time, this repetitive stress can cause irritation and joint damage.

Spinal Injuries or Trauma

Car accidents, sports injuries, or sudden falls may damage facet joints directly or accelerate degenerative changes.

Disc Degeneration

When spinal discs lose height or function, they can place additional stress on the facet joints. This increased pressure may lead to joint inflammation and pain.

Poor Posture and Lifestyle Factors

Prolonged sitting, improper lifting techniques, and lack of core strength can contribute to uneven spinal stress, which may affect facet joint health.

Symptoms of Facet Joint Pain

Facet joint pain can vary in severity and presentation, often making it difficult to identify without proper evaluation. Common symptoms include:

• Localized pain in the neck, mid-back, or lower back
• Pain that worsens with twisting, bending, or arching the back
• Stiffness, particularly after periods of inactivity or in the morning
• Pain that improves when bending forward or sitting
• Tenderness near the affected area
• Pain that may radiate into the shoulders, buttocks, or thighs (usually without numbness or tingling)

Unlike nerve compression conditions such as sciatica, facet joint pain typically does not produce significant numbness, weakness, or sharp shooting pain down the limbs.

Why Facet Joint Pain Is Often Overlooked

Facet joint pain can be challenging to diagnose because its symptoms often mimic other spinal conditions. Imaging studies such as X-rays, MRIs, or CT scans may show degenerative changes, but these findings do not always confirm that the facet joints are the primary pain source.

Additionally, many patients initially assume their pain is muscular or disc-related, delaying proper evaluation. As a result, facet joint pain may go untreated or misdiagnosed, leading to chronic discomfort and reduced quality of life.

How Is Facet Joint Pain Diagnosed?

A thorough evaluation by a pain management or spine specialist is essential for accurate diagnosis. The process typically includes:

Medical History and Physical Examination

Physicians evaluate symptom patterns, movement limitations, and areas of tenderness to identify potential facet joint involvement.

Diagnostic Imaging

While imaging helps identify structural changes, it is often used alongside other diagnostic tools rather than as a standalone confirmation.

Diagnostic Facet Joint Injections

One of the most reliable methods for diagnosing facet joint pain is a diagnostic injection. During this procedure, a physician injects a small amount of anesthetic into the suspected facet joint or surrounding nerve supply. If pain significantly improves following the injection, it strongly suggests the facet joint is the source of discomfort.

Treatment Options for Facet Joint Pain

Fortunately, multiple treatment options are available to relieve facet joint pain and improve mobility.

Conservative Treatments

• Physical therapy focused on strengthening core muscles and improving flexibility
• Anti-inflammatory medications to reduce swelling and pain
• Activity modification to reduce joint stress
• Posture correction and ergonomic improvements

Facet Joint Injections

Therapeutic facet joint injections contain anti-inflammatory medication, typically corticosteroids, which can reduce inflammation and provide longer-lasting pain relief.

Medial Branch Blocks

These injections target the small nerves that transmit pain signals from the facet joints. They may provide temporary relief and help confirm the diagnosis.

Radiofrequency Ablation (RFA)

For patients with chronic facet joint pain, radiofrequency ablation can offer longer-term relief. This minimally invasive procedure uses heat generated by radiofrequency energy to interrupt pain signals from the affected nerves. Relief from RFA can last several months to over a year in many cases.

Lifestyle and Preventative Strategies

• Maintain a healthy weight
• Strengthen core and back muscles
• Practice proper lifting techniques
• Stay physically active
• Use ergonomic workstations

When to Seek Medical Evaluation

Patients should consider seeking medical attention if back or neck pain persists for several weeks, interferes with daily activities, or worsens over time. Early diagnosis and treatment can help prevent chronic pain and improve long-term outcomes.

Finding Relief from Facet Joint Pain

Facet joint pain is a common yet frequently overlooked source of spinal discomfort. Because its symptoms often resemble other conditions, proper diagnosis is key to effective treatment. With modern pain management techniques, including minimally invasive procedures and personalized therapy plans, many patients can achieve meaningful relief and return to normal activities.

If you are experiencing persistent back or neck pain, consulting with a spine or pain management specialist can help identify the root cause and guide you toward effective, lasting relief.