Understanding and Managing Facet Joint Syndrome

At Horizon Spine & Pain of Utah, we are committed to helping patients who suffer from facet joint syndrome, a leading cause of chronic back and neck pain. Our specialized team offers comprehensive diagnosis and a wide range of advanced, minimally invasive treatments designed to reduce pain, restore mobility, and improve your quality of life.

Facet joint syndrome refers to pain originating from the small joints located along the back of the spine. These joints — called facet joints — provide stability and flexibility to the spine. Over time, they can become worn down, inflamed, or injured, leading to facet-mediated pain in the neck (cervical spine), mid-back (thoracic spine), or lower back (lumbar spine).

Learn more about facet joints at Spine-health.com

The most common causes of facet joint syndrome include:

• Degenerative arthritis (osteoarthritis) leading to joint cartilage breakdown
• Trauma or injury (such as whiplash or a fall)
• Repetitive motion or chronic mechanical stress on the spine
• Disc degeneration causes increased load on facet joints
• Spinal instability or previous spine surgery

Facet joint deterioration often occurs naturally with aging but can also result from lifestyle or occupational factors.

You may be at greater risk for developing facet joint syndrome if you:

• Are over 40 years old
• Have a history of spinal trauma or repetitive strain
• Suffer from degenerative disc disease
• Have poor posture or a sedentary lifestyle
• Being overweight adds stress to spinal structures

Addressing modifiable risk factors can help prevent further progression.

Symptoms of facet joint syndrome typically include:

• Localized back or neck pain (often on one side)
• Pain that worsens with twisting, bending backward, or standing
• Stiffness and reduced flexibility
• Radiating pain into the shoulders, buttocks, or thighs (but not usually below the knee)
• Tenderness over the affected joints
• Grinding or popping sensations with movement

Unlike nerve compression conditions, facet joint syndrome pain tends to stay close to the spine.

At Horizon Spine & Pain of Utah, diagnosis involves a multi-step approach:

• Detailed history and symptom review
• Physical examination assessing spinal motion, tenderness, and posture
• Imaging studies:
  • X-rays to detect arthritis or spinal misalignment
  • MRI or CT scans to visualize joint damage or inflammation
• Diagnostic facet joint blocks:
  • Injection of a numbing medication into the suspected facet joint to confirm if it is the source of pain

Facet joint injections are the gold standard for diagnosing facet-mediated pain.

Most patients with facet joint syndrome improve with non-surgical treatments, including:

Medications:

• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Muscle relaxants
• Pain-relieving creams or patches

Physical therapy:

• Exercises to strengthen spinal muscles, improve flexibility, and promote better posture

Lifestyle modifications:

• Weight loss, ergonomic improvements, and core strengthening

Chiropractic care or manual therapy:

• Gentle spinal adjustments to improve mobility

A conservative, comprehensive plan often leads to significant improvement.

For patients needing greater pain control, we offer advanced interventional options:

• Facet joint injections:
  • Deliver anti-inflammatory medication directly into the painful joint
• Medial branch nerve blocks:
  • Target the nerves that transmit pain signals from the facet joints
• Radiofrequency ablation (RFA):
  • A minimally invasive procedure that uses heat to disrupt the nerve fibers carrying pain signals, offering long-lasting relief

Surgery is rarely needed for facet joint syndrome but may be considered if:

• Conservative and interventional treatments fail
• There is significant spinal instability
• Severe arthritis causes structural damage to the spine

Surgical options might include spinal fusion to stabilize the affected area. However, at Horizon Spine & Pain of Utah, surgery should be considered after exhausting non-surgical treatments.

At Horizon Spine & Pain of Utah, we offer:

• Board-certified specialists in spine and pain management
• Precise diagnostic testing, including advanced imaging and diagnostic blocks
• Cutting-edge, minimally invasive treatments for long-term relief
• Personalized care plans tailored to your individual needs

We focus on treating the root cause of your pain, not just the symptoms — helping you achieve real recovery and a return to the activities you enjoy.