Studies show facet joints are responsible for 15–45% of chronic neck pain and 15–52% of chronic low back pain, with degeneration being the leading cause of facet joint disease.
Extra body weight also increases joint stress and raises the risk of developing osteoarthritis in these joints. In the lower back, advanced degeneration can also lead to spondylolisthesis at L4–L5 sections and in the neck, 29% to 60% of whiplash cases involve cervical facet pain.
This is a common pattern and at my Wheat Ridge clinic, many of our patients think their pain comes from a disc issue, but exams often reveal irritated facet joints. With accurate diagnosis and orthopedic exams like Kemp’s test, we can treat the source directly, here’s how.
What Is Facet Joint Syndrome?
Facet joints are small joints located at the back of the spine. They connect each vertebra to the one above and below, guiding movement and keeping the spine stable. Each joint is lined with cartilage and surrounded by a capsule filled with lubricating fluid to allow smooth motion.
Facet joint syndrome occurs when these joints become inflamed, arthritic, or injured. This can limit movement and cause localized pain that sometimes spread to:
- In the neck, facet pain can refer to the shoulders or upper back.
- In the lower back, it can radiate into the buttocks or thighs but usually not past the knee.
Common Causes of Facet Joint Syndrome in Denver, CO
In my Wheat Ridge and Denver patients, these are the most consistent and well-documented causes, that we have treated:
Sciatica
When the sciatic nerve is irritated due to lumbar nerve root compression, the surrounding paraspinal muscles often go into protective spasm. This shifts loading patterns, causing the lumbar facet joints especially at L4-L5 and L5-S1 to take on extra stress, accelerating inflammation.
Hip Osteoarthritis
When the hip joint degenerates, your gait changes. This altered biomechanics causes the pelvis to tilt and rotate abnormally, which increases compressive and shear forces on the lumbar facets.
Sacroiliac Impingement
When the sacroiliac joints lose their normal glide, stress is transferred to the lumbar facets. Over time, this can lead to capsular thickening and cartilage wear within the affected zygapophyseal joints.
Lumbar Radiculopathy
Nerve root compression changes how you move and stand. Protective muscle guarding shortens deep spinal stabilizers like the multifidus, leading to joint compression and eventual irritation in the facet capsules.
Myofascial Pain
Chronic tension in the erector spinae, quadratus lumborum, and multifidus can limit facet joint glide, creating persistent compression that irritates the synovial lining.
Compression Fractures
Fractures often from osteoporosis change vertebral height and alignment, forcing nearby facet joints into abnormal angles that accelerate cartilage wear.
Disc Herniation
When disc height is lost, the vertebrae move closer together, increasing compression on the facet joints. This can irritate the articular cartilage and synovial membrane, especially in the lower lumbar region.
Osteophytes
Bony overgrowth from degeneration narrows the joint space, restricting motion and causing mechanical irritation during spinal extension and rotation.
How We Treat Facet Joint Syndrome at The Disc Chiropractic
When someone walks into my clinic with suspected facet joint pain, my first job is to confirm that the joint is the actual source of their symptoms. Once we know the facets are involved, the treatment goal is simple and here is what I generally recommend for treatment.
Chiropractic Adjustments
I use the Gonstead Method for precise correction. By targeting only the restricted joint and avoiding unnecessary rotation, we can improve alignment and relieve capsule irritation without overstretching the ligaments.
This is especially important in the cervical spine, where delicate structures require exact adjustments.
Spinal Decompression Therapy
For patients with disc height loss or compression alongside facet pain, Our Triton DTS spinal decompression table gently separates the vertebrae using negative pressure to create a vacuum effect, thus reducing the pressure between the joints.
This unloads the facet surfaces and gives the discs and joints space to receive nutrients and naturally recover.
Shockwave Therapy
Facet pain is often aggravated by chronic tightness and poor blood circulation around the joint capsule. Shockwave therapy from the Intelect RPW 2 sends acoustic sound waves deep into the surrounding tissues, breaking down adhesions and scar tissues, thus improving blood flow, and allows the body to stimulate its natural healing process.
Soft Tissue Therapy
When muscles like the multifidus or erector spinae are in constant spasm around an irritated joint, they can lock it down even more. Using the Rapid Release Pro 3, I apply targeted high-frequency vibration to release muscle tension, improve motion, and reduce compressive forces on the joint.
Therapeutic Exercises & Posture Correction
Restoring joint movement is only part of the plan. To keep the pain from coming back, I prescribe specific exercises to strengthen deep stabilizers like the multifidus and transverse abdominis.
We’ll also look at your posture to prevent the kind of uneven loading that can cause the facets to flare up again.
FAQs About Facet Joint Syndrome
What is the main cause of facet joint syndrome?
In most patients, facet joint syndrome develops from degenerative changes in the cartilage that lines the joints. Over time, the protective cartilage wears down, the joint space narrows, and inflammation sets in.
How is facet joint pain diagnosed?
Diagnosis starts with a detailed history and physical exam. Orthopedic tests, like Kemp’s test or extension-rotation maneuvers, can reproduce facet pain by placing stress on the joint. In some cases, imaging like MRI or CT scans can confirm degeneration or narrowing in the facet joint.
Is facet joint pain the same as arthritis?
Facet joint syndrome is often caused by osteoarthritis of the facet joints, but the terms aren’t interchangeable. Arthritis describes the degenerative process in the joint, while facet joint syndrome refers to the pain and functional problems that result from it.
Can facet joint pain go away without treatment?
Some mild flare-ups may calm down with rest and pain medication within 1-2 weeks, but the facet pain is chronic or caused by a degenerative condition; it will require targeted treatment such as chiropractic adjustments or shockwave therapy.
What activities make facet joint pain worse?
Activities that extend or twist the spine tend to aggravate facet joint pain. This can include prolonged standing, leaning backward, or heavy lifting with poor form. In some cases, long hours sitting with poor posture can also load the joints and trigger pain.
Take the First Step Against Facet Joint Pain For Just $97
When facet joints are the source of your pain, the solution is precise care that restores motion, reduces inflammation, and keeps the problem from coming back. My focus is always on addressing the root cause so you can get lasting relief, not just a temporary fix.
If you want a plan that’s clear, science-based, and built for your specific needs, I’d be glad to help you take the next step toward moving freely again.
Book your $97 First Visit today — includes a detailed consultation, full spinal and nerve evaluations, and a custom care recommendation. Call: 720-573-4910