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Anatomy of the Facet Joints

The spine is made up of vertebrae connected by facet joints. These joints provide stability and allow motion such as bending and twisting. Each facet joint is lined with cartilage and surrounded by a capsule filled with synovial fluid, which nourishes the joint and minimizes friction. In facet joint disease, these joints become arthritic, leading to inflammation, stiffness, and pain.

Causes and Risk Factors

Facet joint disease can be caused by a variety of factors, with age-related degeneration being the most common. Over time, the cartilage within the facet joints can deteriorate, leading to bone-on-bone contact and pain. Other risk factors include:

  • Obesity: Excess body weight puts additional stress on the spine
  • Genetics: A family history of spinal issues may increase the risk
  • Overuse or Injury: Repetitive motions or trauma to the spine can accelerate joint degeneration
  • Other Spinal Conditions: Conditions like herniated discs or spinal stenosis can contribute to facet joint deterioration


Symptoms of facet joint disease vary, with a dull, aching pain being the most common. This pain is typically localized to the area of the affected joint and may worsen with certain movements, such as twisting or bending backward. Other symptoms may include:

  • Tenderness over the affected joint
  • Reduced flexibility and stiffness in the spine
  • Radiating pain, numbness, or tingling if nerves are affected
  • Crepitus
  • Stiffness in the morning that improves with movement


At Excel Health, our specialists begin with a detailed medical history review and a physical examination, focusing on the spine’s mobility and identifying specific areas of pain. To further assess the condition, imaging tests such as X-rays, MRI, or CT scans are utilized, providing detailed visuals of the facet joints and revealing any degeneration or inflammation.

The definitive diagnosis is made through a diagnostic facet joint injection. This procedure involves injecting a local anesthetic and an anti-inflammatory into the facet joint. If the patient experiences immediate pain relief following this injection, it confirms the presence of facet joint disease.

Treatment Options

Conservative Care

Conservative treatments are the first line of management for facet joint disease. These may include:

  • Physical therapy to improve flexibility and strength
  • Pain relief medications, including NSAIDs or acetaminophen
  • Lifestyle modifications, such as weight loss and ergonomics adjustments
  • Application of heat or cold to relieve pain and inflammation
  • Facet joint injections to reduce pain and inflammation

Surgical Treatment

Surgery is considered only when conservative treatments fail to provide relief, and the patient’s quality of life is significantly impacted. Surgical procedures for facet joint disease aim to relieve nerve pressure and stabilize the spine. At Excel Health, our experienced surgeons utilize minimally invasive techniques to reduce pain and expedite recovery time.

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