Facet Joint Arthritis: Diagnosis and Treatment Options
December 23, 2025
Facet joint arthritis is a common yet often overlooked cause of chronic neck and back pain. These small joints play a critical role in stabilizing the spine and allowing smooth movement. When arthritis develops in the facet joints, inflammation and degeneration can lead to persistent pain, stiffness, and reduced mobility.
Understanding how facet joint arthritis is diagnosed—and the wide range of available treatment options—can help patients find effective relief without immediately resorting to surgery.
What Are Facet Joints?
Facet joints are small, paired joints located at the back of the spine on each vertebra. They guide spinal motion and prevent excessive twisting or bending. Each joint is lined with cartilage and surrounded by a capsule filled with lubricating fluid.
Over time, normal wear and tear can cause the cartilage to break down, leading to inflammation and arthritis within the joint.
Causes and Risk Factors for Facet Joint Arthritis
Facet joint arthritis most often develops due to age-related degeneration, but several factors can increase risk, including:
- Repetitive spinal stress or heavy labor
- Poor posture or spinal alignment
- Prior spinal injuries or trauma
- Obesity, which increases joint loading
- Degenerative disc disease
- Genetics and inflammatory conditions
As the cartilage thins, bone-on-bone contact can occur, triggering pain and stiffness.
Common Symptoms
Symptoms of facet joint arthritis can vary depending on the location of the affected joints.
Cervical (neck) facet arthritis may cause:
- Neck pain and stiffness
- Headaches
- Shoulder or upper back discomfort
- Pain with head rotation
Lumbar (lower back) facet arthritis may cause:
- Low back pain that worsens with standing or bending backward
- Morning stiffness
- Pain that improves with sitting or leaning forward
- Localized tenderness
Unlike disc-related pain, facet joint pain is typically more localized and less likely to cause numbness or tingling down the arms or legs.
How Facet Joint Arthritis Is Diagnosed
Diagnosis begins with a detailed medical history and physical examination. Your provider will evaluate posture, range of motion, and pain patterns.
Imaging studies may include:
- X-rays to detect joint space narrowing or bone spurs
- CT scans for detailed bone assessment
- MRI to evaluate surrounding soft tissues
In many cases, diagnostic facet joint injections are used to confirm the source of pain. If pain significantly improves after numbing the joint, facet arthritis is likely the primary cause.
Non-Surgical Treatment Options
Most patients find relief with conservative, non-surgical treatments.
Physical Therapy
Targeted exercises improve flexibility, strengthen supporting muscles, and reduce joint stress.
Medications
Anti-inflammatory medications, muscle relaxants, or topical agents may help control symptoms.
Lifestyle Modifications
Weight management, posture correction, ergonomic adjustments, and activity modification can reduce flare-ups.
Interventional Pain Management Options
When conservative treatments are not enough, minimally invasive procedures may offer longer-lasting relief.
Facet Joint Injections
Corticosteroid injections reduce inflammation and pain within the joint.
Medial Branch Blocks
These injections target the small nerves that transmit pain signals from the facet joints.
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RFA uses heat to interrupt pain signals from the medial branch nerves and can provide relief lasting several months or longer.
When Is Surgery Considered?
Surgery is rarely the first-line treatment for facet joint arthritis. It may be considered only when pain is severe, persistent, and associated with spinal instability or nerve compression that does not respond to other treatments.
Living Well With Facet Joint Arthritis
Facet joint arthritis does not have to limit your quality of life. With an accurate diagnosis and a personalized treatment plan, many patients regain mobility, reduce pain, and stay active.
Early intervention, guided therapy, and targeted pain management strategies can prevent symptoms from worsening and help avoid unnecessary surgery.
Final Thoughts
Facet joint arthritis is a common cause of chronic spinal pain, but effective treatments are available. From physical therapy and injections to advanced interventional options, care can be tailored to your symptoms and lifestyle.
If you are experiencing ongoing neck or back pain, a comprehensive evaluation can help determine whether facet joint arthritis is contributing—and which treatment options are right for you.
