Facet Joint Syndrome & Chiropractic Treatment

What Causes Facet Joint Pain?

The facet joints, also known as zygapophyseal joints, are paired joints at the back of each spinal level. They help guide movement and limit excessive rotation and extension.

Facet joint pain can develop after a sudden awkward movement, repeated loading or a period of reduced movement and stiffness. Age-related changes in the joints may also contribute, although changes seen on X-rays or scans do not always explain a person’s symptoms.

What Does Facet Joint Pain Feel Like?

Facet joint pain commonly causes localised pain and stiffness in the lower back. Symptoms may include:

• Pain on one side of the lower back
• Pain slightly to one side of the spine rather than directly in the centre
• Stiffness after sitting or resting
• Pain when twisting or leaning backwards
• Tenderness around the affected area
• Reduced or uncomfortable spinal movement
• Pain that may spread into the buttock, hip or upper thigh

Facet joint pain does not usually cause the typical nerve symptoms associated with sciatica. If you have pain travelling further down the leg, numbness, pins and needles or weakness, we will also assess for possible nerve or disc involvement.

How Is Facet Joint Syndrome Diagnosed?

There is no single examination test that proves a facet joint is the source of pain. Diagnosis is usually based on your symptoms, medical history and physical examination, while considering other possible causes of back pain.

Your assessment may include spinal movement, joint and muscle examination and, where appropriate, neurological testing.

Imaging is not routinely required for uncomplicated back pain. If your history or examination suggests that further investigation may change your management, we will discuss the appropriate next step.

How Can Facet Joint Pain Be Treated?

Treatment depends on the findings from your assessment, how long you have had the problem and how much it is affecting your movement and daily activities.

Where appropriate, treatment may include:

• Spinal mobilisation or manipulation
• Soft-tissue techniques
• Advice about movement and activity
• Exercises to restore movement and strength
• Rehabilitation to improve spinal control and confidence with normal activity

Manual therapy is generally most useful as part of a broader programme that includes exercise and advice rather than as a stand-alone treatment.

Should I Keep Moving?

For most uncomplicated episodes of lower back pain, remaining active and gradually returning to normal movement is encouraged. The appropriate type and level of exercise depends on your symptoms and individual assessment.

Prolonged rest can make stiffness and loss of confidence with movement worse, so we normally aim to help you return progressively to comfortable activity.

Can Facet Joint Pain Come Back?

Back pain can recur, particularly if the underlying factors that contribute to repeated flare-ups remain unchanged. These may include reduced spinal movement, loss of strength, sudden increases in activity or repeated exposure to movements that aggravate the area.

Rehabilitation therefore focuses not only on reducing current symptoms but also on improving movement, strength and tolerance to normal activities.

When Should I Seek Urgent Medical Advice?

Most facet joint pain is not serious. However, seek urgent medical assessment if back pain is accompanied by new bladder or bowel problems, numbness around the saddle or genital area, significant or rapidly worsening leg weakness, severe symptoms in both legs, major trauma, or feeling seriously unwell with fever or shivering.

Facet Joint Pain and Back Pain Treatment

Facet joint syndrome is only one possible cause of lower back pain. You can read more about the different causes, assessment and treatment options on our Back Pain Treatment & Chiropractic Care page.

If you would like an assessment, chiropractic care is available at our
Milton Keynes Chiropractic Clinic,
Northampton Chiropractic Clinic and
Aylesbury Chiropractic Clinic.

What Happens at My First Appointment?

We will discuss your symptoms and medical history, examine the area and explain what we think may be contributing to your pain.

We will then discuss the treatment and rehabilitation options that may be appropriate for you. If we believe further investigation or referral is needed, we will explain this before proceeding.