Facet Joint Pain
Understanding symptoms, causes and treatment for facet joint pain near Andover, Hampshire.
Facet joint pain is one of the most common causes of low back pain. It's often worse when you arch backwards or twist, and tends to be at its stiffest first thing in the morning or after a long drive. If that sounds familiar, the joints at the back of your spine are usually the cause rather than a disc problem, and it tends to respond well to the right conservative treatment.
What Is Facet Joint Pain?
Each bone in your spine, called a vertebra, connects to the one above and below through a pair of small joints at the back known as facet joints. These joints guide how your spine bends and twists. Like any joint in the body, they can become a source of pain when the cartilage inside wears down or becomes irritated, a process closely related to osteoarthritis.
Facet joint pain is usually felt as an ache localised to one side of the lower back, though it can sometimes spread into the buttock or upper thigh. Unlike sciatica, it doesn't typically travel down the leg past the knee, because it isn't caused by pressure on a nerve.
Common Symptoms
Localised low back pain, often on one side
Pain that's worse with arching backwards (extension) or twisting
Stiffness that's most noticeable first thing in the morning or after sitting still
Discomfort that eases with gentle movement once you get going
Pain that may spread into the buttock, hip or upper thigh, but rarely below the knee
Tenderness when pressing directly over the affected joint
Causes and Risk Factors
Age-related wear (osteoarthritis), common from your 40s onwards
Previous injury to the lower back
Repetitive extension or rotation movements, common in certain sports and occupations
Poor postural habits, particularly prolonged standing or sitting with an arched back
Excess body weight, increasing load through the spine
Reduced core strength, which can increase stress on the facet joints
How Common Is Facet Joint Pain?
Facet joint pain is thought to be behind a significant proportion of chronic low back pain. Degenerative changes in these joints become very common with age, and research shows most people in their 60s have some facet joint wear visible on imaging. As with disc changes, these findings don't always cause symptoms. Plenty of people with facet joint wear on a scan have no pain at all.
Diagnosis
Facet joint pain is largely a clinical diagnosis. We'll take a detailed history of your symptoms: what movements bring it on, where exactly you feel it, and how it behaves. This is combined with a physical assessment of your spine's movement and specific tests that tend to reproduce facet-related pain, such as extension and rotation.
Imaging such as X-ray or MRI can show degenerative changes in the facet joints, but because these changes are so common in people without any pain, a scan alone can't confirm that the facet joint is the source of your symptoms. Clinical assessment remains the most reliable way to guide your treatment.
Treatment Options
Osteopathic treatment aims to improve movement through the spine and reduce the load going through the irritated joint, using techniques such as soft tissue release, joint mobilisation and gentle manipulation suited to your presentation.
Osteopathy
Building core and spinal stability, along with improving flexibility in the surrounding muscles, helps take pressure off the facet joints and is a key part of managing symptoms over the longer term.
Rehabilitation
Shockwave Therapy and EMTT
For persistent facet-mediated back pain, Focused Shockwave Therapy and EMTT offer an alternative pathway, particularly where IDD Therapy isn't the right fit since that's aimed at disc-related problems rather than the facet joints themselves. Both aim to stimulate the body's natural healing response in the affected tissues around the joint. This is a newer application for these therapies compared with their established use in tendon conditions, so we'll talk you through whether it's an appropriate option as part of your assessment. Find out more on our Shockwave Therapy and EMTTpages.
When Should You Seek Professional Help?
Facet joint pain often settles with conservative care, but it's worth getting assessed if:
Pain has persisted for more than a few weeks
Symptoms are affecting your sleep or daily activities
You develop numbness, tingling or weakness in your legs
You experience any loss of bladder or bowel control, or numbness around the groin or saddle area. These require urgent medical attention
FAQs
How do I know if my back pain is coming from a facet joint?
Facet joint pain typically has a fairly specific pattern: worse with arching backwards or twisting, better with gentle movement, and staying local to the lower back rather than travelling down the leg. A clinical assessment can help confirm whether this fits your symptoms.
Is facet joint pain the same as arthritis?
Facet joint pain is often caused by osteoarthritic changes within the joint, so the two are closely related. Not everyone with facet joint osteoarthritis on a scan experiences pain, though.
What's the difference between facet joint pain and sciatica?
Facet joint pain comes from the small joints at the back of the spine and tends to stay localised to the lower back, hip or thigh. Sciatica comes from irritation of the sciatic nerve, usually from a disc problem, and typically causes pain travelling down the leg, often past the knee. Read more on our Sciatica page.
Will I need an injection or surgery?
Most facet joint pain is managed successfully with conservative treatment. Injections are sometimes used elsewhere in a patient's care pathway to help confirm the diagnosis or provide short-term relief, but the least invasive options are tried first, and surgery is rarely required.
Can facet joint pain come and go?
Yes. It's common for facet joint pain to flare up and settle in cycles, often triggered by particular postures, activities or periods of inactivity.
Summary
Facet joint pain is a very common, usually manageable cause of low back pain that comes from the small joints at the back of the spine rather than the discs or nerves. With the right conservative treatment, including osteopathy, targeted rehabilitation and, where appropriate, shockwave therapy or EMTT, most people see a real improvement in their symptoms. If backache that's worse with arching or twisting has been bothering you, we're here to help you get to the bottom of it.
Book an appointment.
If you're dealing with persistent lower back pain, book an assessment with us here in Goodworth Clatford, Andover, and we'll help identify what's driving your symptoms and the best way forward. You can book online or call 01264 580280 if you'd like to discuss things first.
If you would like to discuss whether IDD Therapy might be right for you, we offer a free 30 minute discovery call. Call now on 01264 580280
Typical candidates for IDD Therapy are individuals with back, neck, or leg pain who have tried other treatments without success.
They may be on pain medication, have undergone an MRI scan, and might be considering invasive treatments like injections or, in severe cases, surgery.
MRI Scans and Suitability for IDD Therapy
Before beginning IDD Therapy, it’s important to confirm that treatment is appropriate for your condition. An up-to-date MRI scan is essential, as it allows us to see the underlying cause of your back or neck pain in detail.
We work in partnership with Vista Health, a leading nationwide provider of diagnostic imaging. This means our patients benefit from:
Fast access to MRI scans at convenient UK locations
High-quality imaging that gives us a clear understanding of your spine
Affordable options compared with many hospital-based scans
By teaming up with Vista, we can quickly review your scan results and confirm whether IDD Therapy is the right course of treatment for you. This ensures that your care is safe, appropriate, and based on the best possible information.
If you're experiencing back or neck pain, or symptoms affecting your legs or arms, visit us for a professional assessment to determine the most suitable treatment for you.
Clinic Director Mark Stockwell says:
“Our goal is to get you moving freely again. Certain spinal conditions simply need more than standard hands-on treatment and exercise, having IDD therapy we can help people get back to doing the things they love as part of long term care solution.”
To book a consultation or request a callback: 01264 580280
Book an appointment.
You can book an appointment online or call 01264 580280 if you would like to discuss your condition beforehand.
