What is Facet Joint Dysfunction?

Facet joint dysfunction is a condition where the small non-load bearing joints in the spine—called facet joints—become irritated, inflamed, or damaged, leading to pain and limited mobility.

What are facet joints?

Facet joints are pairs of small joints located at the side of each vertebra. They help guide and limit the spine’s movements (like twisting and bending) and provide stability.

What happens in dysfunction?

In facet joint dysfunction, these joints:

  • Lose their normal function due to wear-and-tear (degeneration), trauma, or inflammation.

  • May cause pain, particularly during certain movements.

  • Can become arthritic (facet joint osteoarthritis) or develop capsular irritation (inflammation of the joint lining).

Common causes:

  • Degenerative changes

  • Injury or whiplash

  • Poor posture or repetitive stress

  • Muscular weakness or tightness

Symptoms:

  • Localized back or neck pain

  • Pain that worsens with loading of the facet this is usually with extension (bending back) +/- rotation or side bend.

  • Stiffness or reduced mobility

  • Referred pain - which is pain that extends away from the spine.

  • Tenderness over the affected joints

  • Muscle spasm and guarding

Diagnosis:

  • Subjection and Objective examination - this is usually quite straightforward and will form the basis for treatment

  • Imaging (MRI, CT scan, or X-rays) - this is usually not required.

  • Diagnostic injection to confirm the facet joint as the pain source - this is only in extreme cases and not usually required.

Treatment options:

  • Physiotherapy - this may include manual treatment (massage and joint mobilisation), acupuncture and exercise

  • Anti-inflammatory medications

  • Advice for activity modification, sleep posture and work posture correction.

  • Facet joint injections (corticosteroids or anesthetics) rarely needed.

  • Radiofrequency ablation (RFA): a procedure to disrupt pain signals - rarely needed.

  • Surgery - This is very rare and only considered if all conservative methods fail.

If you are suffering with pain in the spine a full assessment with Victoria at ThamesPhysio can identify if the Facet Joints may be the cause of your pain. Following the assessment a plan for treatment can be made and started.