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Spine Health Redefined

Facet joint syndrome is a condition in which the facet joints – the joints behind and between the vertebrae responsible for the spine’s stability and flexibility – become inflamed and swollen. The result can be localized or radiating back or neck pain, headaches, and limited mobility.

Facet Joint Syndrome

The adult human spine is made up of 33 bones, or vertebrae. Facet joints connect the vertebrae, and provide for the stability and flexibility of the spine. There are two facet joints between each pair of vertebrae, one on each side. Facet joints link each vertebra to those directly above and below it, and allow the vertebral bodies to rotate with respect to each other. Cartilage in the joints allows for smooth movement where vertebral bones meet, and each is lined with a thin membrane called the synovium, which produces synovial fluid for lubrication.

Sometimes, facet joints may become inflamed, irritated or swollen, causing pain and other uncomfortable symptoms due to the impingement, or “pinching” of the nerves that serve the facet joint.

This is called facet joint syndrome.

Potential causes of the condition include inflammation, infection and degeneration of the vertebrae and the discs that cushion and protect them due to aging, trauma and/or poor posture.


The specific symptoms of the condition depend on the location of the affected joint and the nerves that are involved.

  • If the affected joint is in the neck, or cervical spine, it may cause localized and/or radiating neck pain and headaches, and it also may be very difficult to turn your head.
  • If the affected joint is in the lower back, or lumbar spine, it may cause back pain, pain that radiates into the buttocks and legs, and it may become difficult for you to walk or stand.
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To determine whether you have facet joint syndrome, your doctor will examine your back and your medical history, and may order an x-ray, computed tomography (CT) scan of the spine or magnetic resonance imaging (MRI) scan to rule out another disorder as the cause of the pain. Your doctor also may recommend a non-surgical procedure called a facet joint block. This involves injecting a numbing medicine into or near the nerves that supply the facet joint. If there is a significant decrease in pain after the anesthetic is administered, it is considered a confirmation of facet joint syndrome.

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Treatment Options

Facet joint syndrome may be treated with a combination of non-surgical therapies designed to relieve both the inflammation and resulting symptoms, including:

  • Posture correction — Proper alignment of the spine can reduce stress on the lower back and neck.
  • Activity modification — Altering the home and workplace to eliminate excessive twisting, stretching, and bending, as well as learning proper lifting techniques.
  • Exercise/physical therapy — To improve flexibility, strength and circulation, as well as reduce pain and inflammation and increase pain-free movement.
  • Medication — Over-the-counter medications such as non-steroidal anti-inflammatory drugs (NSAIDs) or, if this fails to provide relief, a prescription pain reliever, steroid or muscle relaxer.
  • Facet joint block — In patients for whom it has provided symptom relief during the examination process, a facet joint block also may used as a treatment for facet joint syndrome.

If conservative treatment fails to provide lasting relief, your doctor may recommend spine surgery. Surgical therapies for treating facet joint syndrome include:

  • Laminectomy — A procedure in which the lamina of the affected vertebrae (the portion of the vertebral arch that forms the “roof” of the spinal canal) is removed or trimmed to widen the spinal canal and create more space for the spinal nerves.
  • Spinal fusion — A surgical technique in which one or more of the vertebrae of the spine are joined together (fused) to stop them from moving against each other. This is done by placing bone grafts or bone graft substitutes between the affected vertebral bone. The graft material acts as a binding medium and also helps to maintain normal disc height – as the body heals, the vertebral bone and bone graft eventually grow together to join the vertebrae and stabilize the spine.
  • Radiofrequency rhizotomy (also called radiofrequency neurotomy) — A procedure that involves destroying the nerves in the facet joints with highly localized heat generated through radiofrequency. By destroying these nerves, the communication link that signals pain from the spine to the brain can be broken.

The decision to treat facet joint syndrome surgically requires careful consideration between you and your doctor. Factors to be considered include your specific condition and overall physical health. Discuss your condition thoroughly with your doctor, and rely on his or her judgment regarding which treatment option is most appropriate.

Facet Joint Syndrome Specialist

Facet joint syndrome is a condition where inflammation and pain develop in the joints that link your vertebrae. If you're suffering from painful facet joints, expert surgeons Steve Paragioudakis, MD, and Marc Menkowitz, MD at the Center for the Functional Restoration of the Spine, can help. They have many years of experience treating conditions like facet joint syndrome using non-invasive therapies and, where appropriate, advanced surgical procedures. To benefit from their expertise, call the Shrewsbury, Toms River, or Edison, New Jersey, office for more information or book an appointment online today.

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Facet Joint Syndrome Q & A

What is facet joint syndrome?

What causes facet joint syndrome?

What symptoms does facet joint syndrome cause?

How is facet joint syndrome treated?

What is facet joint syndrome?

Facet joint syndrome is a condition affecting the joints that link your vertebrae together. You have 33 vertebrae in your spine, with two facet joints between each pair of vertebrae, one on either side. These joints provide spinal flexibility and stability. The facet joints possess a cartilage layer that ensures there's no friction between the bones as they move. There's also a membrane (synovium) that lubricates the joint with synovial fluid. If the facet joints are irritated and inflamed, it can cause pain and other unpleasant symptoms because the nerves serving the facet joints become compressed. This condition is known as facet joint syndrome.

What causes facet joint syndrome?

The inflammation that triggers facet joint syndrome could be due to:

  • Infection
  • Osteoarthritis
  • Degenerative disc disease
  • Synovial facet joint cyst
  • Degenerative spondylolisthesis

The effects of aging, acute or repetitive trauma, and poor posture can contribute to the development of facet joint syndrome.

What symptoms does facet joint syndrome cause?

Your symptoms depend on the location of the affected facet joints:

Neck (cervical spine)

Facet joint syndrome in your cervical spine can cause neck pain that often radiates out into your shoulders and arms. You might get frequent headaches and find it very difficult to turn your head.

Lower back (lumbar spine)

Facet joint syndrome in your lumbar spine can cause lower back pain that can spread into your buttocks and legs. You might find it difficult to walk or stand. The first step in diagnosing facet joint syndrome is for the Center for the Functional Restoration of the Spine team to look at your medical history, review your symptoms, and conduct a thorough physical exam. They look for limited movements in your spine and test your muscle strength and reflexes to look for nerve damage. Following your exam, you might need to go for further tests such as X-Rays, a CT or CAT scan, an MRI scan, and a facet joint block.

How is facet joint syndrome treated?

Several non-surgical therapies can relieve both the inflammation and pain present in facet joint syndrome, including:

  • Posture correction
  • Activity modification
  • Exercise and physical therapy
  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Prescription pain relief
  • Steroids
  • Muscle relaxants
  • Facet joint block local anesthetic injection

If these treatments aren't proving effective, surgery might be necessary. Options include laminectomy to widen your spinal canal, spinal fusion to stop the facet joints from moving, and radiofrequency rhizotomy to destroy the nerves in your facet joints. If you're struggling with symptoms of facet joint syndrome, call the Center for the Functional Restoration of the Spine team or book an appointment online today.

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