What is facet joint syndrome?

Facet joint syndrome is a frequent yet often under-recognised source of chronic back and neck pain. Facet joints are small, paired joints that connect the vertebrae in the spine, allowing smooth movement and providing stability. When these joints become irritated, inflamed, or arthritic, they can generate localized pain and restrict mobility—a condition known as facet joint syndrome.

This syndrome typically develops due to age-related degeneration, repetitive stress, poor posture, or acute injury such as whiplash. Over time, the protective cartilage within the joints wears down, leading to friction, inflammation, and stiffness. Many patients describe the pain as a deep ache that worsens with extension or twisting of the spine.

In the lumbar region, discomfort may radiate into the buttocks or thighs, while cervical facet pain can spread into the shoulders or upper back. Unlike nerve-related conditions, facet joint pain rarely causes numbness or tingling, which helps distinguish it during clinical evaluation.

Diagnosis often involves a combination of physical examination, imaging studies, and targeted diagnostic injections. A facet joint block—an injection of anesthetic near the affected joint—can confirm the diagnosis if it provides immediate pain relief. Treatment typically begins with conservative strategies such as physical therapy, posture correction, nonsteroidal anti-inflammatory medications, and activity modification. Strengthening the core and paraspinal muscles can reduce stress on the joints and improve long-term outcomes.

For persistent or severe cases, interventional procedures may be recommended. These include corticosteroid injections to reduce inflammation or radiofrequency ablation, a minimally invasive technique that interrupts pain signals by targeting the small nerves supplying the facet joints. Surgery is rarely necessary.

Facet joint syndrome is a manageable condition when addressed early. With proper diagnosis, lifestyle adjustments, and targeted treatment, many individuals experience significant relief and regain the mobility needed for daily activities.