Facet Joint Syndrome

Facet joint syndrome is pain arising from irritated or arthritic facet joints at the back of the spine.

Facet joints connect neighbouring vertebrae and guide spinal movement while helping limit excessive twisting. Their lining and supporting tissues contain pain-sensitive structures. Age-related joint change, repeated loading, or an injury can irritate these structures. The neck or lower back may be involved; this page focuses on the common lower-back presentation.

Common presentations of facet joint syndrome include lower-back pain and back muscle spasm. Pain may be one-sided or felt on both sides, and can worsen with standing, leaning backwards, or turning. It may spread into the buttock or upper thigh without following a clear nerve route.

Stiffness after inactivity and tenderness near the spine are also possible. Numbness, progressive leg weakness, or new difficulty controlling urination or bowel movements are not typical features and require urgent assessment.

Facet joint syndrome can follow gradual cartilage and joint-lining change, an earlier back injury, or repeated extension and rotation. Disc height changes can also alter the load placed on facet joints. Because several spinal tissues can produce similar pain, the label describes a suspected pain source rather than a finding that can be confirmed from symptoms alone.

Pain often fluctuates with activity and may settle between flares. Guarding can produce muscle spasm and make movement feel more restricted. Recovery depends on the irritant, conditioning, sleep, work demands, and other spinal changes. Persistent or changing symptoms deserve reassessment so nerve, disc, hip, or inflammatory causes are not missed.

Factors that may increase mechanical stress include repeated lifting, prolonged standing, frequent back extension, previous spinal injury, and reduced trunk strength or movement confidence. Age-related spinal changes can contribute. These factors do not prove that facet joints are the source of a particular episode of back pain.

Assessment begins with questions about location, timing, movement triggers, injuries, and nerve symptoms. The clinician checks spinal movement, tenderness, walking, strength, sensation, and reflexes. Imaging may show arthritic change but cannot by itself identify the painful joint. In selected cases, a facet joint injection is used as a targeted diagnostic and treatment step.

Early care may combine pacing, regular movement, heat or cold, and clinician-guided pain relief. Physiotherapy can build trunk and hip strength, improve movement control, and address work or sport loads. A facet joint injection may be considered when pain remains limiting or the suspected source needs testing. Radiofrequency ablation uses heat to interrupt pain signals from selected small nerves and may be discussed when relief from a diagnostic procedure is temporary.

Long periods in one position can aggravate symptoms, so change posture and take brief movement breaks. Keep walking or other tolerable activity in your routine, increasing demand gradually. Use lifting mechanics that keep loads close and avoid repeatedly forcing the lower back into its painful end range. A physiotherapist can tailor exercises to your work, sleep, and sport needs.

Recurring pain may lead to guarded movement, reduced conditioning, disrupted sleep, and difficulty working or exercising. Facet joint change can coexist with narrowing around spinal nerves, although that is a separate problem. Seek urgent care for new bladder or bowel changes, numbness around the saddle area, or worsening weakness in a leg.

No strategy prevents every episode, but gradual strengthening, varied movement, and sensible lifting can reduce avoidable strain. Build tolerance before returning to repetitive bending or extension, and address a flare early with pacing rather than prolonged bed rest. A clinician can review persistent pain or symptoms that spread below the knee.

A musculoskeletal clinician, spine specialist, or physiotherapist can assess ongoing back pain and decide whether facet joints are a plausible source. Bring details about movements that worsen or ease pain, any leg symptoms, previous injuries, and treatments tried. Specialist review is appropriate when pain limits daily activity or does not follow its expected pattern.