Facet Joint Pain

The facets joints are the hinges that link adjacent vertebrae together. There are two joints to each vertebrae, one on each side.  Facet joints help support weight and control movement between each vertebrae.  Facet joint pain can be extremely detrimental to a person’s quality of life because so many of the body’s movements rely on the facet joint.  When the cartilage wears away in between the facet joint space, this causes bone on bone rubbing which can cause bone spurs, as well as narrowing around the medial branch nerves.  The Medial branch nerves carry pain signals directly to and from facet joints.


  • Back or neck pain ( more pain generally when leaning backward)
  • Lower back pain radiates down buttocks into back of upper legs
  • Neck pain radiates into shoulders and upper back, sometimes associated with headaches
  • Mid back pain can radiate into ribs


  • Genetics
  • Normal aging
  • Trauma
  • Obesity/ unhealthy life styles

Screening and Diagnosis:

Complete medical history and physical examination is key in diagnosing facet joint pain. Also, X-ray, CT or MRI may be ordered for further evaluation, but the appearance of facet joints on imaging studies is often not decisive. For patients with joint pain who fail to improve with usual care and for whom facet joint pain is strongly suspected, facet joint block is the most specific mean “the golden rule” to determine if the facet joint is causing pain.


Non-surgical options for facet joint pain include:

  • Physical therapy
  • Chiropractic care
  • Non-steroidal anti-inflammatory medications, muscle relaxants, and some cases pain medication.

Injection Therapy:

  • Facet joint Injection
  • Medial branch block (MBB), which is a diagnostic block, followed by Radiofrequency ablation (RFA)

Related Research Articles

Title: A Systematic Review and Best Evidence Synthesis of Effectiveness of Therapeutic Facet Joint Interventions in Managing Chronic Spinal Pain
Authors: Laxmaiah Manchikanti, MD, Alan D. Kaye, MD, PhD, Mark V. Boswell, MD, PhD, Sanjay Bakshi, MD, Christopher G. Gharibo, MD, Vahid Grami, MD, Jay S. Grider, DO, PhD, Sanjeeva Gupta, MD, Sachin “Sunny” Jha, MD, Dharam P. Mann, MD, Devi E. Nampiaparampil, MD, Manohar Lal Sharma, MD, Lindsay N. Shroyer, MD, Vijay Singh, MD, Amol Soin, MD, Ricardo Vallejo, MD, Bradley W. Wargo, DO, and Joshua A. Hirsch, MD
Journal: Pain Physician

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