Condition guide
Facet Joint Pain
Pain that may arise from the small joints that guide movement in the spine.
Overview
Facet joints are the small paired joints at the back of the spine that guide and limit motion between vertebrae. Like any joint, they can develop arthritis, become irritated by repetitive stress, or contribute to pain after an injury.
Facet-related pain is typically felt near the spine itself, in the neck or low back, and can refer outward to the shoulder blade, buttock, or hip. It is often worse with extension, such as leaning back, or with rotation, and can be stiffest after rest. Because these symptoms overlap with disc pain and other sources, careful evaluation is what distinguishes facet involvement from the alternatives.
Symptoms
- Aching localized to one side of the neck or low back
- Pain with leaning back or twisting
- Stiffness after sitting or resting, easing with gentle movement
- Referred discomfort toward the shoulder blade, buttock, or hip
- Tenderness over the affected spinal segment
- No clear pattern of symptoms traveling down an arm or leg
Possible causes
Age-related arthritis is the most common contributor, but repetitive loading, prior injury, whiplash, occupations or sports involving repeated extension, and altered spinal mechanics after surgery or disc problems can all play a role. Facet pain often coexists with other spine changes rather than occurring in isolation.
How it is diagnosed
History and examination suggest the possibility, but facet joints cannot be reliably confirmed by symptoms or scans alone, since arthritis visible on imaging is common in people without pain. Diagnostic medial branch blocks, which briefly numb the small nerves carrying signals from the facet joints, are the accepted method for clarifying whether these joints are a genuine pain source.
Treatment options
Care often begins with rehabilitation, movement strategies, and activity modification. When diagnostic blocks confirm facet involvement, options include repeat blocks or radiofrequency ablation, which applies controlled energy to those small nerves for potentially longer-lasting relief. Injections directly into the joint are considered in selected situations.
When to see a specialist
Consider an evaluation when localized spinal pain persists despite appropriate conservative care, keeps returning in the same pattern, or is limiting activity. An evaluation is also worthwhile when earlier treatments have not helped and the actual pain source remains unclear.
Common questions
Frequently asked questions
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Start with a conversation about your symptoms and goals.
This information is educational and does not replace an individual medical evaluation. If you have a medical emergency, call 911.