What’s Facet Joint Pain


Your spine consists of sections of facet joints. Cervical facet joints for neck and upper back, thoracic facet joints for your mid-back and lumbar facet joints for the low back.

Facet joint pain (also called facet joint hypertrophy) refers to the painful degeneration and enlargement of the facet joints, which are the small joints located on each side of the vertebra. You might be familiar with the more common name for this condition: osteoarthritis. Just like any other joint, damage to the facet joints may be caused by an injury, degenerative changes, such as normal wear and tear, or the natural effects of aging.

The facet joints function like hinges and are responsible for stabilizing the spine. They limit the motion of the vertebrae to keep your spine aligned, but they also allow for flexibility and rotation in the neck, upper back and the lower back. During your waking hours, the facet joints are nearly constantly in motion. They’re an essential component of your body’s ability to move and function.

The facet joints are encased in cartilage, and over time, this tissue can wear down and develop facet joint arthritis. This is known as facet joint arthropathy, or facet joint hypertrophy. In severe cases, bone spurs may form on the joints, putting pressure on nearby spinal nerves and nerve roots and causing a condition called spinal stenosis.

What Does Facet Joint Pain Feel Like?

Typically, facet joint pain feels like a dull ache, localized to one area of the spine. The pain may be experienced on one or both sides, and often in the lower back or neck. Movements toward the affected joint will cause pain. Standing, twisting the spine, or bending backward will exacerbate the pain while bending forward will take pressure off the nerves.

Risk Factors for Facet Joint Hypertrophy

Facet joint hypertrophy is an exceedingly common source of back pain. It accounts for about 15-40% cases of lower back pain, and about 40-60% cases of neck pain.

Age is one of the primary risk factors, with most cases affecting people over the age of 45. Recent studies found signs of facet joint hypertrophy in 57% of adults over 65, and 89% in adults ages 60-69.

A number of other factors can play a role as well, including:

  • Obesity
  • Genetic predisposition.
  • Work or hobbies that put strain on the back.

Diagnosing Facet Joint Hypertrophy

Diagnosis of facet joint hypertrophy usually begins with a complete history and physical exam. We may order other diagnostic tests to further determine facet joint problems. X-rays may be recommended to determine whether there are abnormalities in your spine. Facet joint arthropathy can be diagnosed using a facet joint injection. Your doctor will locate the source of the pain by injecting an anesthetic or steroid medication at select points along the spine. We can also use this opportunity to explore what types of long-lasting pain treatment will be most effective.

Facet Joint Injections and Pain Relief

At Nuvo Spine, we take a multi-disciplinary approach to alleviating facet pain and improving mobility eliminating the possibility of spine surgery. Our non-surgical treatment options range from conservative to advanced and can be combined and tailored to fit your individual needs and circumstances for pain management. Conservative measures include:

  • Physical therapy: Physical therapists can train you for proper muscle movements to protect your spine.
  • Anti-inflammatory medications
  • Facet joint injections: Also called facet block injections.
  • SpineJet Hydrodisectomy: Jets of water wash away damaged spinal tissue to relieve pressure
  • Vertaflex Superion: A small implant is inserted between the vertebrae, acting as an extension blocker
  • A2M (Alpha-2-Macroglubulin) injections: A2M is an advanced, nonsurgical treatment for osteoarthritis. The A2M protein binds to the enzymes that degrade cartilage cells, protecting joints from further damage and enabling natural healing.
  • PRP

If your pain does not respond to conservative treatment, we can look at more advanced, minimally-invasive measures, such as:

  • Epidural steroid injections
  • Advanced neurostimulation
    A device inserted under the skin interrupts pain signals on their way to the brain
  • Rhizotomy (RFA)

Our award-winning physician is board-certified, specializing in innovative solutions to orthopedic joint and back pain. We make it our mission to serve you and get you the results that you deserve. Contact Nuvo Spine for your consultation today.


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