Facet Joint Neck Pain & Chiropractic Treatment

What Are the Facet Joints in the Neck?

The cervical spine contains seven vertebrae. At the back of the spine are pairs of small joints called facet joints, or zygapophyseal joints.

These joints help guide and control movement between neighbouring vertebrae while contributing to the stability of the cervical spine.

Like other joints in the body, the facet joints contain joint surfaces, a capsule and surrounding pain-sensitive tissues. They can therefore potentially contribute to neck pain.

What Is Facet Joint Related Neck Pain?

Facet joint related neck pain describes pain thought to arise from one or more of the facet joints or their surrounding tissues.

You may also hear terms such as cervical facet pain, facet joint syndrome or facet joint sprain.

In practice, identifying one individual structure as the exact source of neck pain is not always straightforward. A clinical assessment therefore considers the overall pattern of symptoms and examination findings rather than relying on one movement or test alone.

What Does Cervical Facet Joint Pain Feel Like?

The symptoms vary between individuals, but facet-related neck pain may be associated with:

• Pain on one or both sides of the neck
• Stiffness or restricted neck movement
• Pain when turning or extending the neck
• Pain spreading towards the shoulder or shoulder blade
• Pain extending towards the back of the head
• Muscle tightness or tenderness around the neck and upper shoulders

These symptoms are not unique to the facet joints. Disc problems, muscular pain and other conditions can produce overlapping symptoms, which is why assessment is important.

Can Facet Joint Pain Cause Headaches?

Structures in the upper cervical spine can sometimes contribute to pain that is felt in the head rather than only in the neck.

This is one possible mechanism involved in cervicogenic headache, where the headache originates from structures in the neck.

However, not every headache associated with neck pain is cervicogenic. Migraine and other headache disorders can also involve neck pain or stiffness.

Read more about headaches and migraines →

What Can Irritate a Cervical Facet Joint?

There is not always one identifiable event responsible for facet-related neck pain.

Symptoms may sometimes begin following:

• A sudden or awkward neck movement
• An injury or acceleration-deceleration event such as whiplash
• Prolonged or repeated positions that aggravate the neck
• A period of unusually high physical loading
• Changes associated with osteoarthritis or degeneration of the facet joints

In other cases, neck pain develops gradually without an obvious injury.

Is Poor Posture the Cause?

It is tempting to attribute neck pain to one posture, particularly prolonged computer or phone use, but the relationship between posture and pain is more complicated than simply having a “bad” posture.

Remaining in one position for a long time may aggravate symptoms in some people, particularly when the neck is already sensitive.

Rather than trying to maintain one supposedly perfect posture all day, changing position regularly, remaining active and gradually improving strength and movement tolerance may be more useful.

How Do We Assess Suspected Facet Joint Neck Pain?

Your assessment starts with a detailed history of your symptoms, including where the pain is felt, what movements affect it, how it started and whether you have symptoms elsewhere.

The examination may include:

• Neck movement
• Joint and muscular examination
• Strength and neurological testing where appropriate
• Assessment of the shoulder or upper back where relevant
• Clinical tests designed to help identify likely sources of your symptoms

The purpose is not simply to find a painful area. It is to determine whether the pattern appears consistent with a musculoskeletal neck problem and whether there are findings suggesting another diagnosis or the need for further investigation.

Do I Need an X-Ray or MRI for Facet Joint Pain?

Most uncomplicated episodes of neck pain do not automatically require imaging.

X-rays can provide information about the bones, alignment and degenerative changes in the cervical spine, while MRI provides more detailed information about discs, nerves, the spinal cord and other soft tissues.

However, changes seen on imaging are also common in people without neck pain. A scan therefore needs to be interpreted alongside the symptoms and clinical examination.

Imaging may be considered when clinically indicated, particularly if there has been significant trauma, neurological findings are present, another condition is suspected or the result is likely to change management.

Can Chiropractic Care Help With Facet Related Neck Pain?

Many uncomplicated mechanical neck problems are initially managed conservatively.

Depending on the individual assessment, treatment may include manual therapy, joint mobilisation or manipulation, exercise, advice about activity and strategies to restore comfortable movement.

The aim is not simply to treat one joint in isolation. Treatment should address the person’s symptoms, movement and function and be adapted according to their response.

Does Treatment Always Involve Neck Manipulation?

No. Chiropractic treatment does not automatically mean that the neck will be manipulated.

Depending on the examination findings, patient preference and clinical circumstances, treatment may include:

• Joint mobilisation
• Appropriate manual therapy
• Soft tissue treatment
• Exercise and rehabilitation
• Advice about movement and activity
• Modification of aggravating activities

Where manipulation is considered, the chiropractor should explain the proposed treatment, alternatives and relevant risks so that you can make an informed decision.

Should I Keep Moving If My Neck Hurts?

For most uncomplicated mechanical neck pain, complete rest is not usually necessary.

It is generally sensible to remain active within tolerable limits while temporarily modifying movements or activities that clearly aggravate the symptoms.

As the neck becomes more comfortable, movement and exercise can usually be progressed gradually to restore mobility, strength and confidence.

Why Does Facet Related Neck Pain Sometimes Come Back?

Neck pain can recur, but recurrence does not necessarily mean that the same joint has been repeatedly damaged.

Symptoms may be influenced by previous episodes, physical loading, activity levels, sleep, stress, movement tolerance and other individual factors.

Rehabilitation therefore focuses not only on reducing the current symptoms but also on restoring movement and helping you return confidently to normal activities.

Facet Joint Pain or Cervical Disc Problem?

Facet-related pain and cervical disc problems can sometimes produce overlapping neck symptoms, but there are important differences.

A cervical disc problem affecting a spinal nerve is more likely to produce symptoms extending into the arm or hand, particularly tingling, numbness or weakness.

Facet-related pain is more commonly associated with neck pain, restricted movement and referred pain around the shoulder, upper back or head.

These are general patterns rather than absolute rules, so the distinction should be based on the history and examination.

Read more about cervical disc injuries →

When Should Neck Pain Be Assessed Urgently?

Most neck pain is not caused by a medical emergency. However, some symptoms require prompt medical assessment.

Seek urgent medical advice if neck pain is associated with:

• Significant or rapidly worsening weakness in an arm or leg
• Increasing clumsiness or loss of coordination in the hands
• New difficulty walking or significant balance problems
• New bladder or bowel disturbance associated with neurological symptoms
• Severe symptoms following significant trauma
• Severe illness, fever or other concerning systemic symptoms

These symptoms do not necessarily mean that a serious condition is present, but they require appropriate medical assessment.

Other Problems That Can Cause Similar Neck Pain

Neck pain and stiffness are not always caused by the facet joints.

Other possible explanations include problems involving the cervical facet joints, narrowing around a spinal nerve, shoulder conditions and irritation or compression of peripheral nerves elsewhere in the arm.

This is why treatment should be based on the overall clinical picture rather than assuming that one painful movement identifies a particular injured joint.

Facet Joint Neck Pain Treatment Near You

Milton Keynes

Our Milton Keynes clinic provides assessment, chiropractic treatment and rehabilitation for neck pain and suspected facet-related symptoms, with on-site X-ray facilities where clinically indicated.

Northampton

Our Northampton clinic assesses and treats neck pain and facet-related symptoms, with chiropractic care, rehabilitation and on-site X-ray facilities where appropriate.

Aylesbury

Our Aylesbury clinic provides assessment and treatment for neck pain and suspected facet-related symptoms, with on-site X-ray facilities where clinically indicated.

Frequently Asked Questions About Facet Joint Neck Pain

Is a facet joint sprain the same as facet joint syndrome?

The terms are sometimes used interchangeably, although they do not necessarily describe exactly the same process. Both are commonly used to describe pain thought to arise from a cervical facet joint or its surrounding tissues.

Can facet joint pain spread into my shoulder?

Yes. Neck structures can refer pain towards the shoulder, shoulder blade or upper back. However, shoulder problems and other conditions can cause similar symptoms.

Can facet joint pain cause arm numbness or tingling?

Facet-related pain itself would not usually be expected to cause significant neurological symptoms such as persistent numbness or weakness in the arm or hand. These symptoms may suggest involvement of a spinal nerve or another neurological problem and should be assessed appropriately.

Will I need an X-ray?

Not necessarily. Imaging is not automatically required for uncomplicated neck pain. X-rays or other imaging may be considered when the clinical findings indicate that the result is likely to help diagnosis or management.

Does a chiropractor have to manipulate my neck?

No. Treatment can include several approaches, and neck manipulation is not automatically required. The treatment recommended should depend on the clinical findings, your individual circumstances and your preferences.

Start by Understanding What Is Causing Your Neck Pain

Neck pain and stiffness can have several possible causes. A careful assessment can help determine whether a facet joint or another structure may be contributing and whether treatment, rehabilitation or further investigation is appropriate.