Facet Joint Syndrome

Facet Joint Syndrome

Facet joint syndrome is a common cause of chronic back and neck pain, often linked to age‑related spinal wear. It occurs when the small joints between the vertebrae become inflamed or degenerate over time, resulting in persistent discomfort, stiffness, or limited movement.

At The New Foscote Hospital, we offer expert diagnosis and treatment of facet joint pain — from conservative therapies to spinal injections and, where appropriate, surgery. Our orthopaedic and pain management specialists tailor care to your symptoms, lifestyle and long‑term goals.

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What Are Facet Joints?

Facet joints are small stabilising joints located at the back of the spine, connecting one vertebra to another. These joints guide movement and help support weight, especially in the lumbar (lower back) and cervical (neck) regions.

With age or injury, the cartilage in these joints can wear down, leading to facet joint syndrome — a form of spinal osteoarthritis.

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Symptoms of Facet Joint Syndrome

Symptoms depend on the level of the spine affected but often include:

• Persistent localised back or neck pain
• Stiffness, especially after periods of rest
• Pain that worsens with twisting, bending or arching
• Referred pain to the buttocks, thighs, or shoulders (not below the knee or elbow)
• Tenderness over the affected joints
• Reduced range of motion

Symptoms are typically worse in the morning or after long periods of inactivity.

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Causes and Risk Factors

Facet joint degeneration may be caused by:

• Ageing – natural wear and tear of the joints
• Poor posture – especially with prolonged sitting or driving
• Repetitive stress – lifting, twisting, or bending
• Previous spinal injury
• Obesity or deconditioning
• Underlying spine conditions, such as disc degeneration

Facet joint syndrome is more common in people over 50 but can affect younger adults with certain occupational or lifestyle factors.

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Diagnosis

Diagnosis typically involves a combination of:

• Clinical assessment – based on symptoms and spinal movement
• MRI or CT scan – to detect joint degeneration or narrowing
• Diagnostic facet joint injections – using local anaesthetic to confirm the pain source

At The New Foscote Hospital, we offer access to advanced imaging and expert consultant review to confirm the cause of spinal pain.

Explore our diagnostic services

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Treatment Options

Conservative Treatment

Most patients start with non-surgical care, which may include:

• Physiotherapy – to strengthen supporting muscles and improve posture
• Pain management – including anti-inflammatories or muscle relaxants
• Activity modification – to avoid flare-ups and improve spinal alignment
• Heat or ice therapy – to reduce inflammation and stiffness

Injections and Interventional Pain Management

If pain persists, image-guided injections may help:

• Facet joint injections – a combination of anaesthetic and steroid
• Medial branch blocks – to target the nerves supplying the joint
• Radiofrequency denervation (ablation) – uses heat to block pain signals from the joint

Learn more about pain management treatments

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When Is Surgery Considered?

Surgery is rarely the first option but may be considered in cases of:

• Persistent, disabling pain that doesn’t respond to other treatments
• Confirmed joint degeneration with mechanical instability
• Co-existing spinal problems (e.g. disc degeneration, spondylolisthesis)

Spinal fusion may be considered to stabilise the affected area in select cases. Your consultant will discuss the risks, benefits, and recovery timeline if surgery is advised.

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Why Choose The New Foscote Hospital?

• Consultant-led orthopaedic and spinal care
• On-site access to imaging and pain management services
• Personalised treatment plans for chronic spinal pain
• Private, calm hospital setting with minimal waiting times
• Dedicated support before, during and after treatment