Facet Joint Syndrome
Facet joints, also known as zygapophyseal or z-joints, are the joints found between the vertebrae in your spine. When the surfaces that make up these joints become irritated, inflamed, or arthritic and cause pain it is known as Facet Syndrome.
Presentation
Facet Syndrome often occurs in the lumbar (low back) region, however, is also commonly seen in the cervical (neck) region. Research suggests that 15-45% of low back pain can be due to the facets. Pain that is caused by Facet Syndrome usually presents as local pain but it can also radiate towards the arms and legs. When pain travels down the legs it often terminates above the knee. Radiating pain can also be indicative of a disc/nerve root irritation however Facet Syndrome lacks neurological deficits which are often seen in cases of a disc herniation. The extension (bending back) coupled with rotation (turning) is the most aggravating position in the neck and low back and when located in the low back arising from a flexed or forward bent position is often painful as well. Facet Syndrome is seen more commonly in adults who are middle-aged and older.
Cause
The facet joint and the capsule surrounding it can themselves be a source of pain however pain can also be caused by synovial folds also known as meniscoids which become entrapped.
How We Can Help
If you believe you have Facet Syndrome, or if you have neck or low back pain and are unsure what’s causing it, seeking evaluation and care from a healthcare professional such as the doctors here at Radius is advised. We can help you obtain an accurate diagnosis for your condition and help you escape pain and restrictions.
Source(s): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6206372/
About the author
Dr. Austin Van Poole, DC
Active Rehab Chiropractor
Dr. Austin Van Poole is a compassionate and results-driven chiropractor based in Nevada City, California, focused on musculoskeletal rehabilitation, soft tissue therapy, and active care for injury recovery and performance enhancement. Known for his empathetic approach and dedication to patient-centered care, Dr. Van Poole is passionate about helping individuals reduce pain, regain function, and reclaim the active lives they love. Whether treating acute injuries, chronic pain, or sports-related conditions, he delivers personalized care plans focused on movement optimization and long-term wellness.
More from Dr. Austin Van Poole →Frequently Asked Questions
Common questions about facet joint syndrome.
What is facet joint syndrome?
Facet joint syndrome is back or neck pain arising from the facet joints (also called zygapophyseal or z-joints), the small paired synovial joints between adjacent vertebrae that guide the spine's movement. Clinically it is defined as unilateral or bilateral back pain that may radiate to the buttocks, groin, or thighs, typically stopping above the knee. The facet joints are thought to account for roughly 15% to 45% of low back pain.
What does facet joint syndrome feel like?
Facet joint syndrome usually causes local (axial) back or neck pain with stiffness, and it can radiate. In the lumbar spine the pain may spread into the buttocks, groin, and thighs, typically ending above the knee, and it occurs without the neurological deficits seen with a disc or nerve-root problem. Pain is often worse in the mornings and after periods of inactivity, and tends to increase with extension and rotation of the spine.
What causes facet joint syndrome, and who is at risk?
The most common cause of facet joint syndrome is degenerative osteoarthritis of the facet joints, in which the cartilage cushioning the joint wears down; trauma, repetitive overuse, poor mechanics, and disc degeneration can also contribute. Risk tends to increase with age, and facet joint osteoarthritis is very common in older adults — one dataset reported it in 89% of people aged 60 to 69. Extra body weight and back-straining work or hobbies may also raise risk.
How is facet joint syndrome diagnosed?
Facet joint syndrome is diagnosed from the history, referred-pain pattern, and physical examination, supported by imaging such as X-ray, MRI, or CT. However, history, exam, and imaging may suggest but cannot confirm the facet joints as the pain source. Diagnostic facet (medial branch) blocks — injecting numbing medication near the joint's nerves and watching for pain relief — are the mainstay for confirming the diagnosis, though false positives can occur.
How is facet joint syndrome managed without surgery?
Conservative, non-surgical care is the first-line approach for facet joint syndrome. It is typically a multimodal mix of activity modification, physical therapy, and anti-inflammatory or other pain medication (such as NSAIDs or acetaminophen), sometimes with muscle relaxants, weight management, and manual therapy. Physical therapy focuses on exercise programs that improve flexibility, strength, and posture and strengthen the muscles that support the spine to reduce stress on the facet joints.
The information on this website is general education about musculoskeletal and movement-related conditions. It is not medical advice or a diagnosis, and it cannot tell you what is causing your symptoms. Reading it is not a substitute for an in-person evaluation, and booking a visit does not confirm that your condition is right for our care until a provider has examined you. This information cannot identify every condition, and some urgent problems can feel like musculoskeletal pain. If your symptoms are severe or getting worse, or you are unsure how urgent they are, contact your physician, call 911, or go to the nearest emergency room. When in doubt, seek emergency care.
