Facet Syndrome (Spinal Joint Arthritis)


Facet arthritis is a syndrome of the small zygapophysial joints or synovial joints from the cervical (neck), lumbar (lower back), and thoracic (upper/middle back) regions and is one of the root causes of localized or axial back or neck pain. The facet joints are well lubricated and allow for nearly 20% rotation in the lumbar, cervical and thoracic regions. They are also well innervated by small medial branch nerves that carry pain signals, often manifesting in back pain or spasm.


  • Osteoarthritis
  • Trauma
  • Bone Spurs or Reactive Bone Formation


  • History and physical exam. Pain is often localized to the lower back and neck. Evaluation of the spine reveals pain and limitations with range of motion.
  • Imaging studies such as Radiographs, MRIs, CT Scans and Bone Scans can help diagnose Facet Syndrome.
  • Diagnostic nerve blocks (also called medial branch blocks) can be diagnostic if they provide significant short-term pain relief.


  • Non-steroidal anti-inflammatories and other analgesic medications.
  • Physical therapy to strengthen core muscles.
  • Radiofrequency neurotomy of the small medial branch sensory nerves that innervate the facet joints.
  • Spinal decompression surgery.

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