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Facet Pain

Each section of the spine has facet joints, which are located between the vertebrae. When they are located in the neck, they are called cervical facet joints. When they are located in the mid back, they are called thoracic facet joints and when they are in the lower back, they are called lumbar facet joints.

There are also a left and a right facet joint in each spinal motion segment. These facet joints guide and limit movement of the spine in that area. Facet joint pain can caused by weak muscles that are unable to stabilize the neck and spine. It can also be caused by degenerative disc disease that leads to more bone-on-bone contact within the facet joint.

Warning Signs & Symptoms

Facet pain symptoms:

  • Hypomobility: Joint stiffens
  • Hypermobility: Joint becomes extremely loose (loosening)
  • Locking: Joint cannot move or it is painful to move it. For instance, if it locks in a flexed forward position, arching backwards will be difficult or impossible.
  • Muscle spasm

The initial injury can actually occur well before noticing any symptoms.

Possible Risk Factors

Hypomobility (stiffening) can be due to a number of things:

  • Arthritis
  • Bone spurs
  • Joint scarring, thickening or shortening
  • Muscle spasm

Hypermobility (loosening) is typically caused by trauma:

  • Arthritis
  • Fracture or dislocation 
  • Stretched ligaments

A locked facet joint is typically caused by facet joint motion exceeding muscle control:

  • Awkward, unanticipated movement, like tripping
  • Having a previous locked facet joint
  • Running, bending, twisting

Tests to Diagnose Facet Pain

Facet pain can mimic the symptoms of other types of neck and back problems. Therefore, it’s important to have a skilled physician to accurately determine the source of the pain for appropriate treatment.

Facet joint paint is diagnosed by a physical exam to analyze symptoms, as well as a complete medical examination including health history. Physicians may also use imaging such as an MRI, CT scan or X-ray to view the affected facet joint and better understand how to treat the pain.

Treatment Options

Treatment options for painful facet joints can include destroying the nerves with radiofrequency lesioning, steroid injections, heat or ice and lumbar belts. Since a hypermobile joint is moving excessively, patients need to begin a muscle control and stabilization program. With hypomobile joints, regular exercises can help strengthen the muscles that support your spine.

For locked facet joints, a physician may be able to unlock the joint using a manual joint releasing technique. Several sessions may be needed in order to restore function to the joints and support healing. After this process, strengthening exercises are needed in order to regain full motion and help prevent a future locked facet joint.


Sometimes, accidents occur and result in facet pain. One step to prevent accidents is to assess the home for tripping hazards and remove them. You may also decide to limit or stop participating in activities or sports where your spine could twist or become injured.

One of the best ways to minimize risk of facet injury and pain is to maintain good health, which includes regular exercise, both cardiovascular and exercise that strengthens your spine, neck and back.