Spinal Problems Joint Pain

Facet joints connect each vertebra (bone) of the spine with the adjacent vertebrae. Facet joints commonly degenerate, resulting in back pain. However, acute back pain caused by spine facet joints is generally intermittent and unpredictable.

Spine facet joints can degenerate due to:

  • Back or neck injury
  • Degeneration of intervertebral disc
  • Wear and tear on the spine joints.

As the spine joints degenerate, cartilage wears away, causing the bone to rub together. This causes osteoarthritis of the facet joints, sometimes accompanied by bone spurs and enlarged joints. This condition is also called facet joint disease or facet joint syndrome.

To confirm a diagnosis of facet joint syndrome, the doctor injects an anesthetic and an anti-inflammatory into an affected joint. If the injection produces immediate pain relief, the condition is facet joint syndrome.

Facet Joint Syndrome Symptoms

When the facet joints are inflamed, the muscles that run along the spine go into spasm, called muscle guarding. This muscle spasm is a common cause of back pain. In addition to pain, many people also have tenderness around the inflamed joints.

If neck facet joints are affected, symptoms may include:

  • Difficulty moving the head
  • Headaches
  • Shoulder or upper back pain.

Facet joint syndrome may also cause pain in the lower back, buttocks or back of the upper legs. This pain and stiffness may make it difficult to stand up straight or get out of a chair.

Facet Joint Syndrome Treatment

Aside from rest, initial treatment for back pain due to facet joints may include:

  • Heat to relax muscles
  • Ice to reduce inflammation
  • Medication to relieve pain and inflammation
  • Physical therapy to improve muscle strength and flexibility, and deal with issues such as poor posture that contribute to pain.

Other modalities that may provide pain relief from inflamed facet joints include:

  • Acupuncture
  • Chiropractic care
  • Massage therapy.

Facet joint blocks involve injecting steroids into the joint to relieve pain and inflammation. This is only a temporary fix, and the injections have potential side effects that you need to discuss with your doctor.

For long-term pain relief from facet joint syndrome, you may want to consider a rhizotomy. In this surgery, your doctor will use a freezing tip or electrified hot probe to destroy some of the nerve endings serving the affected joints. In unusually severe cases, a doctor may even suggest bone fusion surgery.

Synovial Cysts

Another possible result of facet joint degeneration in the lumbar spine is synovial cysts. These cysts are benign, fluid-filled sacs that can develop as the body attempts to protect the joints. Many people have synovial cysts with no symptoms, and these cysts rarely cause serious problems.

However, if a synovial cyst is large enough, it can cause narrowing of the spinal canal (spinal stenosis), which places pressure on spinal nerves and causes pain. Treatment for these large cysts may range from observation or pain medications to physical therapy or chiropractic care. Medical professionals will usually only consider surgery if the pain is severe and chronic and interferes with daily living.


Cedars-Sinai Staff (n.d.). Facet joint syndrome. Retrieved March 22, 2010, from http://www.csmc.edu/5758.html

Delamarter, R. M.D. and Walsh, M. (2009). Synovial cysts in the spine. Retrieved March 22, 2010, from http://www.spineuniverse.com/conditions/synovial-cysts-spine

Oregon Health and Science University Staff. (n.d.). Facet joint syndrome. Retrieved March 22, 2010, from http://www.ohsu.edu/xd/health/services/ortho/getting-treatment/facet-joint-syndrome.cfm

Ray, C. M.D. (2002). Facet joint disorders and back pain. Retrieved March 22, 2010, from http://www.spine-health.com/conditions/arthritis/facet-joint-disorders-and-back-pain

Ray, C. M.D. (2002). Symptoms and diagnosis of facet joint problems. Retrieved March 22, 2010, from http://www.spine-health.com/conditions/arthritis/symptoms-and-diagnosis-facet-joint-problems

Ray, C. M.D. (2002). Treatment options for facet joint pain. Retrieved March 22, 2010, from http://www.spine-health.com/conditions/arthritis/treatment-options-facet-joint-pain