How to Mitigate and Treat Facet Joint Pain

Facet joint pain often stems from the natural wear and tear of the small joints in your spine, called facet joints.

When aging, arthritis, or a spinal injury affects them, you may experience pain and stiffness that make everyday tasks a challenge.

From difficulty getting out of a chair to feeling discomfort when twisting or bending backward, facet joint issues can significantly impact your mobility.

Below are the key causes, symptoms, and strategies you can consider for alleviating facet joint pain. This guide highlights effective nonsurgical approaches such as physical therapy, posture correction, and medication. It also explores more advanced therapies, when conservative measures prove insufficient.

By combining multiple techniques tailored to your needs, you can regain mobility and comfort in your daily life.

Understanding Facet Joint Pain

Facet joints link your vertebrae. They allow controlled motion and help bear a portion of your body’s weight.

However, over time, these joints can undergo degenerative changes. Cartilage may wear away, and inflammation can occur. As a result, the nerve endings in and around the joints become irritated, producing pain signals.

• Wear and Tear: Natural aging is a primary cause of facet joint pain. When you reach your 40s, 50s, or 60s, the protective cartilage on your facet joints can thin out. 
• Arthritis or Other Conditions: Facet joint pain commonly shows up in individuals prone to osteoarthritis, facet arthropathy, and facet arthrosis.  
• Injury and Trauma: Car accidents, sports injuries, or a spinal fracture can exacerbate or trigger facet joint issues.  
• Additional Contributors: Obesity, poor posture, or carrying heavy loads can place extra stress on the spinal joints and amplify painful symptoms.

Facet joint pain may also develop alongside other spinal conditions, such as chronic spondylosis or radiculopathy, compounding the discomfort.

If your pain primarily appears in the lower back, you may be dealing with lumbar facet syndrome. When the upper spine is affected, it could be symptoms of cervical facet syndrome.

Regardless of its location, prompt evaluation of your condition can help prevent further joint damage.

Recognize Common Symptoms

Understanding your symptoms lets you communicate effectively with healthcare providers and pinpoint the best relief strategies. Facet joint pain can vary considerably between individuals, but some common complaints include:

Localized Aching  

You might experience a constant dull ache over the affected spinal area. This discomfort often worsens first thing in the morning or after prolonged sitting.  

Reduced Range of Motion  

Facet joint problems may make bending or twisting painful. For some, leaning backward is particularly aggravating, while bending forward might provide temporary relief (UCHealth).  

Radiating Pain  

In the lumbar region, you could feel pain radiating to your buttocks or the backs of your thighs (Weill Cornell Medicine). If nerves become pinched, you might also notice tingling or numbness in the legs.  

Morning Stiffness  

Spine stiffness that makes it difficult to stand upright is common. You may feel like your back is “locked up” when you first try to move.  

Worsening After Activity  

Exercises that involve repetitive bending, heavy lifting, or twisting (for instance, certain golf swings) can make you more aware of your facet joint pain.  

Difficulty With Daily Tasks  

Simple movements like turning the head to check your blind spot or reaching for high shelves may become challenging if you have chronic facet pain in the neck.

If you find that these symptoms persist or worsen, consult a medical professional. Early detection and treatment methods often yield better results, especially if imaging tests like MRI or CT scans are used to confirm a diagnosis (Spine-Health).

Explore Nonsurgical Options

For many, facet joint pain will improve through nonsurgical measures. These methods target inflammation, muscle tightness, and other pain-related factors to help you regain mobility without the risks involved in surgery.

Here are some of the most effective nonsurgical strategies:

Self-Care and Lifestyle Measures

• Posture Correction: Proper posture can significantly reduce stress on your facet joints. Try adjusting your workspace to ensure your computer monitor is at eye level. Make sure your chair provides adequate lumbar support.  
• Weight Management: Carrying excess weight may accelerate joint wear. Maintaining a healthy body weight through balanced nutrition and moderate exercise can ease strain on your spine.  
• Avoid Strenuous Movements: For a time, you may need to modify or pause exercises that trigger pain. If you notice specific movements exacerbating your discomfort, consider reviewing facet joint pain exercises to avoid with a qualified professional.

Physical Therapy

A consistent physical therapy routine often delivers significant relief. Therapists typically use a combination of manual therapy, low-impact aerobic exercise, core and back strengthening exercises, and stretching routines.

These steps, done regularly, can stabilize your spine to prevent further irritation:

• Stretching Routines: Focus on lengthening tight back muscles to reduce tension in the facet joints.  
• Strengthening Exercises: Work on your abdominal and low back muscles to provide additional support for your spine.  
• Spinal Manipulative Therapy: Performed by trained professionals, gentle mobilizations can help realign the spine and reduce pain signals.  

Medication and Topical Treatments

Several medications and topical creams can help manage symptoms:

• Anti-inflammatory Drugs (NSAIDs): Help control swelling and discomfort within the joint.  
• Muscle Relaxers: May ease muscle spasms commonly associated with back pain.  
• Topical Gels or Patches: Products containing menthol or capsaicin can deliver localized, temporary relief.  

Always consult your physician for guidance on the effective dosage and duration of these medications.

Other Treatments

Several other self-care approaches can help soothe your pain:

• Heat Therapy: Applying a warm compress or heating pad to the affected area can loosen tight muscles, increase circulation, and alleviate stiffness (Spine-Health).
• ‍Cold Therapy: Ice packs numb localized pain, especially after physical activity or a flare-up.  
• Bracing or Support Belts: For short periods, a supportive back brace can maintain ideal spinal alignment, although long-term use might weaken core muscles and is not typically recommended.

Consider Injections and Ablation

When facet joint pain persists despite conservative treatment, injections and radiofrequency ablation can offer substantial relief. These methods primarily target inflammation and nerve signals that carry pain.

Steroid Joint Injections

Also referred to as facet injections, this minimally invasive option involves corticosteroids and local anesthetic delivered directly into the facet joint.

According to UCHealth, the relief you experience can last anywhere from several days to multiple years, depending on your condition.

• Procedure: Performed under fluoroscopy or ultrasound guidance, the needle is inserted precisely into the affected joint.  
• Benefits: Quick reduction in inflammation, decreased pain, and improved range of motion.  
• Limitations: Pain relief may be temporary. Repeated injections are possible but need monitoring for potential side effects.

In certain cases, your specialist might consider ultrasound guided facet injection to ensure accurate placement of the medication.

Radiofrequency Ablation

Radiofrequency ablation (RFA) uses heat from radiofrequency waves to destroy the small nerves near the facet joint that send pain signals to the brain (UCHealth). It offers longer-lasting relief than steroid injections for some people.

• Procedure: A thin probe is positioned near the target nerve under imaging guidance, and an electrical current heats and disables those nerve fibers.  
• Duration of Relief: Can last anywhere from nine months to over two years. Some patients repeat the procedure if the nerves regenerate.  
• Ideal Candidates: Individuals who have confirmed pain relief from a diagnostic nerve block prior to ablation.

Both injections and ablations may be combined with physical therapy and lifestyle modifications for optimal results.

Employ Lifestyle Strategies

Facet joint pain rarely improves without making changes to your daily routine. While medical interventions are crucial, adopting healthier habits can support and maintain your treatment outcomes.

Stay Active Within Reason

Prolonged inactivity can weaken supportive back muscles, exacerbate stiffness, and heighten pain. Consider low-impact exercises such as walking or swimming, which strengthen the spinal stabilizer muscles without placing undue stress on your facet joints. Even short walks can be beneficial if done consistently.

Optimize Nutrition

A nutritious diet helps you maintain a healthy weight and provides your body with the nutrients necessary for tissue repair. Focus on a balanced intake from major food groups, particularly lean proteins, fruits, vegetables, and whole grains. If you’re unsure about your nutritional needs, a registered dietitian or healthcare provider can create a plan tailored to your condition.

Practice Good Sleep Hygiene

Quality sleep supports overall musculoskeletal health and helps your body repair from daily wear. Experiment with different mattress firmness levels to find support that minimizes spinal strain. Pillows under the knees or between the legs can reduce pressure on your lower back when side-sleeping.

Mind Posture Throughout the Day

Maintaining a neutral spine is essential in alleviating pressure from your facet joints. Whether sitting at your desk, strolling through the grocery store, or lifting an object, aim to keep your shoulders relaxed and back vertical. If you regularly drive for extended periods, adjust your seat to fully support your lumbar region.

Know When to Modify Activities

Although staying active is important, certain movements can aggravate your pain. High-impact sports, bending backward repetitively, and twisting at the waist under load might worsen your symptoms. Always listen to your body. If a particular action causes a sharp increase in pain, scale back or avoid it. You might also consider exploring facet joint degeneration or facet joint arthritis resources to better understand how these conditions progress and what activities to limit.

Look at Surgical Interventions

While most cases of facet joint pain are managed successfully through nonsurgical methods, some individuals need surgery or other advanced interventions to address spinal instability or nerve compression.

Spinal Fusion or Other Surgeries

A fusion procedure stabilizes the affected vertebrae by “fusing” them together with bone grafts or hardware. If your facet joint pain is linked to additional spinal conditions, such as lumbar spondylosis or severe facet arthropathy, your surgeon may recommend this path.

Other surgical options include laminectomy, discectomy, or a facetectomy to remove damaged tissue (Sciatica.com).

• Consideration: Surgery involves more risks than conservative measures, including infection and longer recovery times.  
• Ideal Candidates: People who do not find lasting relief from injections, physical therapy, or radiofrequency ablation, or those with complex spinal issues like spinal fracture.

The Role of Regenerative Therapies

Ongoing research explores options like facet joint regeneration, prolotherapy, and hydrodissection. These regenerative treatments inject substances intended to stimulate tissue repair.

While promising, they are often considered experimental, so consult your specialist to find out if these therapies are suitable.

When to Seek Additional Help

If your pain significantly interferes with your mobility or quality of life, it is time to consider more formal assessments.

Consulting a spine specialist or orthopedic surgeon can help you determine whether advanced diagnostic tests or higher-level interventions, such as nerve ablation or surgery, are necessary. You may also want a second opinion before pursuing surgical options.

Remember, adopting a multifaceted approach can increase your chances of success. Many patients gain the best outcomes by combining self-care, physical therapy, and medical treatments.

You might explore resources on facet joint syndrome to gain deeper insights into this common spine condition. A well-informed plan, mapped out with your healthcare team, can be the turning point in reducing facet joint pain and allowing you to move with confidence again.

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 

Using a minimally-invasive hydrodissection technique, RELIEF® gently separates and releases adhered fascia and 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.