Facet joint pain is back or neck pain from worn, inflamed facet joints. Where it hurts follows the level involved. It can be neck and shoulder pain with headaches. It can be upper back, chest and arm pain. Or it can be lower back, hip, buttock and leg pain that flares when starting a movement. Most cases are treated without surgery, with diagnostic injections and medial branch blocks.
Facet joints are tiny joints that keep each segment of the spine stable and guide how it moves. These joints link the bones (vertebrae) of your spine. The disc acts as a spacer between the vertebrae and supports the motion. So the disc and facet joints work like a tripod. Damage to one affects the others. This is known as facet joint syndrome.
Causes of facet joint dysfunction
The facet joints in your lumbar spine (low back) wear out most easily, because they bear the most weight and take the most strain. Facet joints of the cervical (neck) and thoracic (mid-back) spine can also cause lasting pain. Facet joint pain most often occurs at the L4-L5 level of the lumbar spine. Statistics show it accounts for 59.6% to 66.7% of all low back pain complaints in men and women. It is a type of arthritis in the spine’s joints that causes severe back and neck pain. Wear-and-tear changes in the joints between the spine’s bones cause it. The cartilage inside the facet joint can break down and become inflamed. That sends pain signals to nearby nerve endings. The discs between the vertebrae are mostly water. With age, they dry out, and the space between the vertebrae shrinks. The condition often shows up with wear-and-tear spine problems such as degenerative disc disease and spondylosis (spinal osteoarthritis). It happens mainly in older people. But younger people can get it from injury or exhaustion. Damage to the facet joint can lead to long-term or permanent impairment.
What are the symptoms of facet joint pain?
It is most often linked to the lumbar spine. Still, it can also affect the cervical and thoracic spine. The type of syndrome you get depends on which part of the spine is affected.
- Cervical Facet Joint Syndrome: It is a kind of osteoarthritis in which one or more of the spine’s joints break down. The cervical vertebrae make up the top of the spine, in the neck. Shoulder and neck pain from facet joint disease can limit how far you can move. It can make it hard to turn your head with ease. Headaches are one symptom of damage to the cervical spine.
- Thoracic Facet Joint Syndrome: Thoracic facet syndrome (also called thoracic facet disease) is a form of spinal arthritis. The facet joints of the thoracic (middle) spine wear down and grow stiff over time. Thoracic facet joints (in the upper spine) often cause pain in the upper back, chest, and arm.
- Lumbar Facet Joint Syndrome: Lumbar facet joints (in the lower spine) often cause lower back, hip, buttock, and leg pain. Inflammation of these joints can cause stiffness and trouble getting up. The most common symptom is pain when starting a movement.
How is facet joint pain diagnosed and treated?
Facet Joint Pain Treatment – Injection Procedure A facet joint injection procedure is a fairly easy and quick procedure. It is often done in an office or outpatient surgery center. Diagnostic injections work by injecting a local anesthetic and an anti-inflammatory drug into the area where joint pain is suspected. If pain eases and mobility is returned shortly after injection, your doctor has likely found the pain source. You can then start a treatment plan built to address it. Medial branch blocks and intra-articular injections (shots into the joint itself) may be part of your plan to find facet joint pain. The doctor will determine which injection fits you best. Intra-articular injections contain a pain-relieving anesthetic and steroids. They help relieve back pain caused by joint inflammation. Medial branch block injections work on the branch nerves instead. These nerves come from the facet joints and send pain signals to the brain.
Do you need surgery for facet joint pain?
The good news: most cases of facet joint problems can be treated without surgery. Spine surgery is used to relieve pain in only a small percentage of patients. Lumbar fusion is done with a minimally invasive method from the front or the back. Diagnostic injections can pinpoint the source of your pain. Your doctor can prescribe non-surgical and minimally invasive facet joint pain treatments. They help you manage your pain and get back a healthy range of motion. You can explore more pain relief treatments offered by Padda Institute to fit each person’s needs.
Frequently asked questions
How do you relieve facet joint pain?
Most facet joint pain is treated without surgery. The first step is a diagnostic injection of a local anesthetic and an anti-inflammatory drug into the suspected joint. If the pain eases and movement returns, the source is found. From there, intra-articular injections of anesthetic and steroid calm the inflamed joint. Medial branch blocks target the small nerves that carry the pain signal to the brain.
What causes facet joint pain?
Wear and tear. The cartilage inside the facet joints breaks down and becomes inflamed. That sends pain signals to nearby nerves. The discs between the vertebrae lose water with age. So the space between vertebrae shrinks, and the facet joints take more strain. The lower back, most often at L4-L5, carries the most weight and is hit hardest. Younger people can develop it after an injury.
Is facet joint pain serious?
It can be. Facet joint syndrome is a form of arthritis in the spine that causes severe back and neck pain. Damage to a facet joint can lead to long-term or even permanent impairment. It can limit how far you turn your head or make it hard to get up. The good news is that most cases respond to non-surgical, minimally invasive treatment.
Does facet joint pain go away?
Waiting it out is a gamble, because damage to a facet joint can cause long-term or permanent impairment. Treatment is what changes the picture. Once diagnostic injections pinpoint the painful joint, targeted injections and nerve blocks help you manage the pain. They help you get back a healthy range of motion. Spine surgery is needed only for a small percentage of patients.
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Dr. Gurpreet Singh Padda, MD, MBA, MHP
