Facet Arthropathy Causes, Symptoms & Treatments

Facet arthropathy is a condition that affects the small, flexible joints along your spine, causing inflammation, stiffness, and pain. These joints, known as facet joints, guide and stabilize the movement of each vertebra as you bend, twist, or reach.

When the surfaces supporting these movements wear down over time, you may develop facet arthropathy. If you have been experiencing persistent back or neck discomfort that limits your daily activities, understanding how facet arthropathy develops—and what you can do about it—may help you find effective relief.

Below, you will explore how these joints function, why they become painful, the symptoms you might notice, and the range of treatments available.

By taking proactive steps and learning about the therapies that work best for facet joint issues, you can potentially regain your mobility and quality of life.

Understanding Facet Arthropathy

What Are Facet Joints?

Facet joints link each adjacent vertebra in your spine, helping you bend and twist with stability. These joints have cartilage surfaces and are bathed in synovial fluid, which helps minimize friction during movement. Over time, however, these protective layers can gradually wear away, leading to rough and inflamed joint surfaces. That deterioration can trigger pain and limit mobility.

Facet joints are present at each level of your spine, from your neck (cervical region) to your mid-back (thoracic region) and lower back (lumbar region). When a facet joint degenerates in the lower spine, the condition is sometimes called lumbar facet syndrome. Similarly, it may be referred to as cervical facet syndrome when it affects the neck area.

Facet Arthropathy Explained

Facet arthropathy refers to arthritis occurring in these facet joints. As it progresses, you may hear related terms such as facet arthrosis, facet degeneration, or facet hypertrophy—all describing varying degrees or associated changes of this degenerative wear and tear.

While facet arthropathy often appears as you age, it can sometimes remain symptom-free. Still, many people do experience discomfort as cartilage loss worsens.

Research findings show that the lumbar facet joints alone are responsible for 15–45% of chronic low back pain cases (PMC).

Imaging studies such as MRI and CT scans often show signs of degenerative joint changes at these levels, but in many instances, a positive facet joint block test under imaging guidance provides more reliable evidence of whether these joints are truly the source of your pain.

Causes Of Facet Arthropathy

The primary cause of facet arthropathy is age-related wear and tear. As you grow older, the cartilage within your facet joints thins, and the lubricating synovial fluid may decrease.

With less cushioning, the bones can rub against each other, causing inflammation and pain. Over time, small bone spurs can form around the joint margins. This process tends to accelerate in individuals with lifestyles or occupations that involve repetitive twisting or heavy lifting.

Some additional factors can add stress to the joints and contribute to wear:

• Poor posture: Angling your spine incorrectly for long stretches (sitting or slouching) can put uneven pressure on your facet joints.  
• Spinal injuries or trauma: Accidents or spinal fracture events can shift the way your vertebrae align, causing the facet joints to bear more strain.  
• Genetic predisposition: If a close relative has a history of osteoarthritis, you may inherit a higher risk of facet joint problems.  
• Preexisting conditions: Disorders like spondylosis, lumbar spondylosis, or radiculopathy can alter the mechanical balance in your spine, intensifying wear on the facet joints.

Recognizing The Symptoms

Facet arthropathy symptoms often involve localized pain in the lower back, neck, or even the middle of your spine. Typically, you might notice:

• A dull ache that flares into sharper discomfort with certain movements  
• Stiffness, especially after waking up or sitting in one position too long  
• Pain radiating into surrounding muscles, sometimes leading to tension or spasms  
• Worse symptoms when twisting, arching your back, or leaning backward  
• Temporary relief when bending forward, which often opens up the facet spaces

In the lower spine, you may feel discomfort in your buttocks or thighs. For neck involvement, you could have pain that radiates into the shoulders or base of your skull. Some people also experience “locking” sensations when trying to twist the torso or fully rotate the neck. If you have persistent, significant pain that affects your day-to-day activities, it is important to see a spine specialist or orthopedic physician. A thorough evaluation can help pinpoint the root cause of your discomfort, which may also include related conditions like facet joint syndrome.

Diagnosing Facet Arthropathy

Your healthcare provider may start with a medical history and a physical exam, followed by imaging studies like X-rays, MRI, or CT scans. Although these tests can confirm structural changes in your facet joints—such as cartilage thinning or bone spur growth—they do not always correlate perfectly with your actual pain levels. For instance, imaging might reveal substantial signs of facet damage, but you may have mild symptoms, or vice versa.

One more definitive diagnosis method is a facet joint block, also called a medial branch block. In this procedure, a numbing agent is injected around the nerve that supplies your facet joint. If your pain lessens significantly during this test, it suggests that facet arthropathy is indeed the main source of your discomfort (NCBI). Precise diagnosis allows for targeted treatments that often bring better results.

Non-Surgical Treatments

Many people with facet arthropathy find that non-surgical interventions can reduce pain and increase mobility without the need for more invasive measures. These approaches often involve a blend of self-care, medication, physical therapy, and procedure-based treatments.

Self-Care And Lifestyle

• Posture Awareness
  Maintaining good posture aligns your vertebrae properly, easing pressure on the affected joints. Whether you are sitting at a desk or standing in line, keep your spine neutral and your shoulders back.
• Heat And Cold Application
  Using hot packs can improve circulation and loosen tight muscles. Cold packs help numb acute flare-ups and decrease inflammation. Many people alternate between heat and cold to maximize relief (Spine-Health).
• Gentle Exercises
  Low-impact activities like walking, swimming, or cycling can promote flexibility in your spine without adding excessive stress. If you experience facet-related pain, you might need to check which facet joint pain exercises to avoid so as not to worsen your condition.
• Proper Ergonomics
  Position your computer monitor at eye level. Adjust your chair height so your knees are at or just below hip level. These small changes reduce repetitive strain on the spine.

Medications And Injections

• Over-The-Counter Remedies
  Anti-inflammatory drugs (NSAIDs) and analgesics can be helpful, especially during acute flares.
• Steroid Injections
  Corticosteroid injections into or around the facet joint can reduce inflammation, offering significant pain relief that may last for days, months, or even years (UCHealth). These injections often contain a combination of a steroid and a numbing agent.
• Radiofrequency Ablation
  If injections help but your pain returns soon after, radiofrequency ablation (RFA) could be the next step. RFA uses heat to temporarily “shut down” the nerve signals coming from the facet joint, reducing chronic pain for longer periods (PMC). Some providers may call this neurolysis or facet thermal ablation.

Physical Therapy Strategies

A structured physical therapy program, guided by a trained therapist, can be invaluable for managing facet arthropathy:

• Manual Therapy: Gentle mobilizations and manipulations can improve joint alignment.  
• Strength Training: Exercises that focus on your core and back muscles reduce strain on the facet joints by supporting better posture.  
• Flexibility Drills: Targeted stretches can help you maintain a healthy range of motion and prevent stiffness from worsening.  
• Low-Impact Cardio: Activities such as stationary biking or walking on a treadmill build endurance while staying gentle on your joints.

If you are integrating home routines, be sure to consult your physical therapist for tailored advice. Combining physical therapy with treatments like injections or medications typically boosts the odds of long-term relief.

Surgical Options

Although non-surgical approaches remain the first line of treatment for facet arthropathy, surgery may become necessary if conservative measures have failed or if your condition is severe.

• Spinal Fusion
  In cases involving advanced degenerative changes or spinal fracture complications, a spine fusion procedure may be recommended (UCHealth). During fusion, your surgeon uses bone grafts and possibly hardware to lock two vertebrae together, eliminating painful motion at the arthritic facet joint.
• Other Interventions
  Some newer, minimally invasive spine procedures aim to preserve more of your natural movement while removing or stabilizing damaged joints. Depending on your unique spine anatomy, your surgeon might discuss advanced techniques like facet joint regeneration or ultrasound guided facet injection as part of your treatment plan.

Before committing to any surgical option, it is crucial that you discuss the risks, benefits, recovery timeline, and expected outcome with a qualified spine specialist. Many of these procedures may involve an extended period of rehabilitation to ensure you regain full function.

Managing Your Long-Term Recovery

Like many chronic spine conditions, facet arthropathy often requires a comprehensive, ongoing management plan. You might combine strategies such as:

• Consistent Exercise Routine: Regular, low-impact activities help maintain improved posture and muscle strength gained from physical therapy.  
• Healthy Weight Management: Carrying extra weight can increase pressure on the facet joints. Gradual weight loss, if needed, might lighten the load on your spine.
• Periodic Check-Ins: Some individuals benefit from occasional steroid injections or prolotherapy sessions if pain flares recur.  
• Balanced Lifestyle: Adequate sleep, stress reduction techniques (like meditation or gentle stretching), and healthy nutrition can all play a role in preserving spine health.

Staying proactive with pain-relief measures, supportive tools (like back braces), and check-ups reduces the chance of flare-ups. If you notice a sudden change in your pain or mobility—such as numbness in your legs or arms—you should contact your healthcare provider promptly. Untreated spinal issues can worsen over time, making early intervention a priority.

Seek RELIEF®

RELIEF® is an evidence-backed, minimally invasive treatment designed to target dysfunctional fascia and irritated soft tissues surrounding the spinal structures—especially the facet joint capsules that help stabilize and guide spinal movement.¹ When these fascial layers become inflamed or adhered from degenerative arthritis, repetitive strain, or injury, they can restrict spinal motion and increase mechanical pressure on the facet joints and nearby nerves; contributing to chronic back or neck pain.^2,3 

The RELIEF® treatment combines a hydrodissection technique to mechanically disrupt scar tissue and adhesions, while delivering amnion-based biologics solution that can decrease inflammation and support regenerative tissue healing.⁷ This may help restore healthy tissue mobility around the facet joints, and reduces mechanical irritation in the spinal motion segment—without steroids, surgery, anesthesia, or prolonged downtime^.4,5,6

If you’re in the Miami area and experiencing facet joint pain, spinal arthritis, or other spine-related mobility limitations, contact us today to learn how RELIEF® may help restore comfort, spinal motion, and overall functional recovery.