Facet Joint Syndrome
Pain from arthritis or injury in the small joints at the back of the spine, often worse with twisting.
Facet joint syndrome is pain from the small joints that link the vertebrae at the back of the spine, most often caused by arthritis. It usually causes a localized ache in the low back or neck that worsens with twisting, arching backward or standing for long periods. Dr. Patel confirms the facet joints are the source with diagnostic blocks, then treats them with injections or radiofrequency ablation if needed.
- Where it isBack & spine
- Treatment options03
- Who you seeAnup H. Patel, D.O.
- First visitExam and imaging review
Facet Joint Syndrome
Each vertebra connects to the ones above and below it through a pair of small facet joints at the back of the spine. Like the knee or hip, these joints are lined with cartilage and wrapped in a joint capsule. They guide and limit movement, allowing you to bend and twist while protecting the spine from too much motion.
Over time, the cartilage in the facet joints can wear down, just as it does in other joints. A joint may become inflamed, form bone spurs and enlarge. Injuries such as whiplash or a fall can also damage these joints. When they become a source of pain, this is called facet joint syndrome or facet arthropathy.
Facet pain is usually a deep ache on one or both sides of the spine. In the lower back it can spread into the buttock or upper thigh, but rarely below the knee. In the neck it can spread to the shoulders or the back of the head. It is often worse in the morning, after sitting still, and with twisting or leaning back.
MRI alone cannot confirm facet pain, because joint arthritis is common in people without pain. The most reliable test is a diagnostic block: numbing the small medial branch nerves that supply the joint and seeing whether the pain eases. When it does, Dr. Patel may recommend radiofrequency ablation, which for many people provides relief lasting several months to a year.
What it feels like · Why it happens
Mention these at your first visit. It saves time and helps focus the exam.
- Osteoarthritis and age-related wear of the joints
- Degenerative disc disease, which shifts more load onto the facet joints
- Whiplash and other injuries from car accidents or falls
- Repetitive twisting or arching in work or sports
- Spondylolisthesis, where a vertebra slips and stresses the joints
- Excess weight and posture habits that increase load on the back of the spine
Where Dr. Patel looksHow Dr. Patel finds the source
Treatment only works when it is aimed at the right thing. This is how the source is confirmed.
- Step 01
A history and exam, including whether pain increases with leaning back and rotation
- Step 02
X-rays, CT or MRI to look for arthritis and rule out other causes
- Step 03
Medial branch blocks: numbing the nerves to the joint to see if pain improves
- Step 04
Often a second confirming block before radiofrequency ablation
- Step 05
Facet joint injections, which can also serve as a diagnostic test
- Step 06
A pain diary in the hours after each block to measure your response
Your path to relief
Care moves one step at a time, from the least invasive option up, and only as far as you need.
First-line care
- Physical therapy for core strength, flexibility and posture
- Exercises that reduce excess arching of the lower back
- Anti-inflammatory medications during flares, when appropriate
- Heat to ease stiffness
- Weight management
- Workstation and sleep position changes for neck facet pain
Targeted treatment
Back to function
As a rehabilitation physician, Dr. Patel pairs every treatment with a plan to rebuild strength, movement and daily activity, so relief lasts.
Physical medicine & rehabilitation
Medial Branch Blocks
A short-acting test that numbs the nerves to the spine’s facet joints to see if they cause your pain.
Radiofrequency Ablation
Heat applied to small pain-carrying nerves to quiet joint pain in the spine, knee or hip for months.
Facet Joint Injections
Medicine placed in a small spinal joint to find and ease arthritis pain in the neck or back.
When to call
When to see a specialist
- Back or neck pain that lasts more than a few weeks
- Pain that is worse with standing, twisting or leaning back
- Morning stiffness that limits your routine
- Neck pain or headaches after a car accident
- Pain that has not improved with therapy and medication
- Relief from earlier facet injections or ablation that has worn off
Go to the emergency room if
- Back or neck pain with fever, unexplained weight loss or a history of cancer
- New leg or arm weakness, or loss of bladder or bowel control, which point to a different problem that needs urgent care
Questions
How is a medial branch block different from a facet joint injection?
How long does radiofrequency ablation last?
Why can’t my MRI show facet pain?
Is facet pain the same as arthritis?
Will facet pain spread into my leg?
This page explains a condition or treatment in general. It is not a diagnosis or medical advice for you. Dr. Patel will explain what applies to you at your visit.
Back & spine
Back Pain
Aching, stiff or sharp pain in the back, from strained muscles to disc, joint and nerve problems.
Sciatica
Pain that runs from the lower back or buttock down the leg, caused by an irritated nerve root.
Herniated Disc
A disc whose soft center pushes through its outer ring, causing back or neck pain and nerve symptoms.