By William Hogan, MD
Blanchard Valley Pain Management

Back pain is one of the most common medical complaints, affecting millions of Americans every year. While conditions like herniated discs, stenosis, and pinched nerves are often the suspected culprits, in many cases, the true source is facet joint pain.

What Are Facet Joints?
The facet joints are small stabilizing joints between each vertebra that allow flexibility and movement in the spine. Like other joints in the body, the facet joints can become inflamed or arthritic, or sustain injury over time from repetitive stress, trauma, or degenerative changes.

Facet joints are well-supplied by medial nerves from the spinal cord. When these joints malfunction and become painful, they can produce significant back and neck pain that radiates into the shoulders, hips, buttocks, or legs.

How Common is Facet Joint Pain?
Facet joint issues are thought to be a primary cause of chronic spine pain in up to 45% of patients. While facet disorders can affect any age group, they are more prevalent in older adults due to years of repetitive stress and arthritic changes.

Signs & Symptoms of Facet Pain
Patients suffering from facet-mediated pain typically experience chronic, dull aching in the back or neck; pain that worsens with activity/movement; stiffness and loss of spine flexibility; muscle spasms and tenderness around the affected area.

For some, facet joint pain is localized. For others, it radiates into the shoulders, buttocks, hips, or legs in a pattern that may mimic other spine conditions. This can make an accurate diagnosis quite difficult.

Diagnosing Facet Joint Pain
Providers use a variety of methods to diagnose facet disorders, including physical examination assessing spine mobility and pinpointing pain sources; diagnostic facet joint injections which numb the suspected joints for temporary relief; and imaging like X-rays, MRI, or CT scans to visualize joint damage or inflammation. 

Treatment Options
While facet joint pain doesn't have a permanent cure, it can be very effectively managed through:

• Facet joint injections/medial branch blocks – steroid injections that reduce inflammation in affected joints
• Radiofrequency Ablation (RFA) – using heat to disable the nerves transmitting the pain signals
• Physical therapy – range of motion and strengthening exercises
• Oral medications such as NSAIDs, muscle relaxants, or neuropathic pain relievers
• Alternative therapies such as acupuncture, massage, or chiropractic care
• Interventions such as facet rhizotomy, stabilization, or fusion surgery (in severe cases)

Don't resign yourself to chronic back pain. If you suffer from persistent spinal pain and have not found relief, facet joint dysfunction could be the underlying cause.