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Could Your Back Pain Be Facet Joint Syndrome?

December 11 | 2023
Posted by Sharon Tierney

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What is a facet joint?


Image of 2 vertebrae showing the body, spinous processes, and transverse processes

Facet joints are located in the spine and are part of the vertebrae. The vertebra has two basic parts. Firstly, the body and secondly, the spinous process which is the bony part you can feel on your back that runs from the neck to just above the buttocks.

The joint from one inferior facet (transverse process) of the top vertebrae to superior facet of the bottom vertebrae is called the facet joint. As a result, they are called the connection joint from one vertebrae to another.

Facet joints are present on both sides of vertebrae. Facet joints increase in joint space when doing forward bending movements,  and compression while moving backward. Similarly, facet joints also help in twisting and rotation movements of the spine. Finally, they also prevent these movements from happening over their normal physiological limits.

What is facet joint syndrome or pain?

Facet joint pain can be due to a condition like osteoarthritis or due to other spinal conditions like spondylolisthesis or stenosis. Alternatively, other causes involve obesity-linked arthritis, aging, heavy and repetitive work duties or secondary to other trauma.

Facet joint pain can occur anywhere along the course of your spine the cervical, thoracic or lumbar areas. Usually, facet joint pain or syndromes present as pain on the back which is localized or radiating. In the lumbar spine, it could radiate down to your buttocks or leg. Additionally, if it’s in the neck, it could be localized or radiating down to the hands.

Overall, the symptoms vary depending on the severity and level of joint involvement.

Other symptoms:

  • Stiffness
  • Painful bending/ rotation
  • Depending of the area involved it has difficulty like sit to stand, standing up straight

How is it diagnosed?

Facet joint pain/ syndrome may be investigated by an x-ray/ MRI but this is not enough to confirm diagnosis. Instead, the gold standard for diagnosis is the use of a diagnostic injection of a joint block into the area. Then, it is considered positive if the patient experiences immediate relief of their pain and symptoms.

From a physiotherapy point of view, it can be diagnosed by using a special test called quadrant test to confirm involvement of facet joint.

In addition, physiotherapists perform other tests which involves looking for flexibility, range of motion, strength,  palpation of tender areas, and a sensory examination to check nerve root involvement.


From a medical perspective, facet joint pain can be treated by using anti-inflammatory injections or cortisone injections by healthcare provider.

For example, a physiotherapy treatment may involve:

  • Education
  • Manual therapy
  • Electrotherapy
  • Hot and cold therapy
  • Exercises mainly focusing on core and lower back strengthening 
  • Traction machine 
Core exercise that may be part of treatment for facet joint syndrome

Image by Freepik

Overall, the patient can be treated with a combination of the above treatment protocols. Importantly, treatment will be individualized based on your specific symptoms and presentation. You will be guided by the expertise of a physiotherapist throughout your journey.

In conclusion, if you are experiencing back pain or are experiencing any of the above symptoms, PhysioNow can you help you out. We have many experienced physiotherapists that can help you with your facet joint pain. Book with PhysioNow today for your first assessment and treatment!

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