What Are Facet Joints?
Facet joints (also called zygapophyseal joints) are small joints located between the bones of your spine (the vertebrae). Each vertebra connects to the one above and below it through a pair of facet joints – one on each side of the spine.
What they do:
- Guide and control movement of the spine (such as bending, twisting and extending)
- Provide stability, helping to prevent excessive motion
- Help distribute weight and load along the spine
Structure:
Facet joints are synovial joints, meaning they have:
- Smooth cartilage covering the bone surfaces
- A joint capsule
- Lubricating fluid (synovial fluid)
What Is Facet Joint Syndrome?
Facet joint syndrome refers to pain arising from irritation or damage to the facet joints in the spine – those small joints that link each vertebra.
Common symptoms
Facet joint syndrome usually causes localised pain rather than nerve-type pain:
- Dull, aching pain in the neck or lower back
- Pain that may worsen with:
- Twisting
- Bending backward (extension)
- Standing for long periods
- Stiffness, especially after rest or in the morning
- Pain that may spread to the shoulders, buttocks or thighs (but typically not below the knee or into the hands)
How it differs from a disc problem
Facet joint pain is often confused with disc problems, but it typically does not cause sharp, shooting nerve pain down the arm or leg. It tends to be more mechanical and localised in nature.
Common Causes of Facet Joint Syndrome
Facet joint syndrome usually develops from a combination of wear-and-tear, mechanical stress and injury affecting the small joints of the spine.
Common contributing factors include:
Age-related degeneration Natural ageing is among the most significant factors. Cartilage in the joints gradually wears down, joint surfaces may become rough and inflamed, and this process is essentially osteoarthritis of the spine.
Poor posture and prolonged sitting Modern habits can play a role. Slouching or forward-head posture places uneven pressure on facet joints, and long hours sitting — particularly at a desk or while driving – can overload certain areas of the spine.
Repetitive strain and overuse Repeated movements may irritate the joints over time, including frequent twisting, bending or arching backward. Jobs or sports involving heavy lifting or rotation (such as manual labour, golf or gymnastics) are common examples.
Injury or trauma Sudden forces can place significant stress on the joints, including whiplash (common in car accidents), falls, awkward lifting or sports injuries.
Degenerative disc changes Facet joints can become stressed when nearby discs weaken. Conditions such as degenerative disc disease reduce disc height, which may shift more load onto the facet joints and accelerate wear over time.
Spinal alignment issues Structural factors such as scoliosis (a curved spine), hyperlordosis (an excessive inward curve of the lower back) or uneven joint loading may contribute to increased stress on facet joints.
Signs and Symptoms of Facet Joint Syndrome
Facet joint syndrome typically causes mechanical, localised spine pain rather than sharp nerve pain. The exact presentation will depend on whether it affects the neck (cervical spine) or lower back (lumbar spine), but there are common patterns.
Core symptoms:
- Localised pain in the neck or lower back
- Dull, aching discomfort (sometimes sharper with certain movements)
- Stiffness, particularly after resting or in the morning
- Reduced range of motion (difficulty turning, bending or straightening)
Pain triggered by movement — symptoms may worsen with:
- Bending backward (arching/extension)
- Twisting the spine
- Standing for long periods
- Sudden movements or lifting
Symptoms may ease with sitting (in lumbar cases), gentle movement or changing position.
Pain patterns by region:
Neck (cervical facet joints):
- Pain in the neck
- May spread to the shoulders or upper back
- Headaches, particularly from the base of the skull
Lower back (lumbar facet joints):
- Pain in the lower back
- May spread to the buttocks or thighs
- Typically does not extend below the knee
How Is Facet Joint Syndrome Treated?
Treatment for facet joint syndrome is usually stepwise, starting with simple, non-invasive options and progressing to procedures only if needed. The general goals are to reduce irritation, restore movement and address contributing factors to help prevent recurrence.
How Chiropractic Care May Help
Chiropractic care for facet joint syndrome focuses on supporting joint movement, reducing irritation and improving how the spine manages load. It is generally considered as part of a broader conservative management approach, and individual results will vary depending on your specific presentation.
Spinal manipulation (adjustments)
Spinal manipulation is the most well-known chiropractic technique. It involves gentle, controlled force applied to restricted spinal segments, with the aim of improving mobility of the facet joints and reducing associated muscle tension. Some people find this helpful for the stiffness associated with facet irritation, though responses vary between individuals.
Mobilisation (low-force techniques)
Where high-velocity adjustments are not appropriate, mobilisation may be used instead. This involves slower, repetitive movements within the joint’s range of motion. It is less forceful than manipulation and is often considered for more sensitive or acute presentations.
Postural correction and ergonomics
Addressing contributing habits forms an important part of longer-term management. This may include advice on sitting, standing and sleeping positions, workstation setup, and strategies for reducing spinal strain during daily activities.
Exercise and rehabilitation
Chiropractors may also prescribe specific exercises as part of your management plan, which could include core strengthening, stretching of tight muscle groups, and movement retraining (such as how to bend, lift and twist more safely).
If you are experiencing spinal pain or symptoms consistent with facet joint syndrome, it is important to seek a thorough assessment from a qualified healthcare professional to determine the most appropriate management approach for your individual needs.
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