Facet Joint Osteoarthritis (OA)

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Facet joint osteoarthritis (OA) is a common cause of chronic back and neck pain, particularly among older adults. It affects the facet joints—small stabilizing joints located between vertebrae—where cartilage gradually wears down, leading to inflammation and reduced mobility. Studies suggest that facet joint OA contributes to up to 15–45% of chronic low back pain cases, especially in individuals over the age of 60^[1]. Contributing factors include aging, spinal injuries, repetitive movements, and even genetics. By understanding its causes, symptoms, and treatment options, individuals can take proactive steps toward effective pain management and improved spinal health.

What Is Facet Joint Osteoarthritis?

Facet joint OA is a type of spinal arthritis that occurs when the cartilage within the facet joints begins to break down due to wear and tear. This degeneration is often linked to aging but may also be caused or accelerated by spinal injuries, poor posture, or chronic strain. In many cases, facet joint OA originates as a result of spinal disc degeneration. As discs lose height and elasticity, more pressure is placed on the facet joints, leading to inflammation, joint damage, and potential nerve irritation. Depending on which part of the spine is affected, this can result in localized pain or radiating discomfort.

Types

Facet joint OA can occur in different regions of the spine, each presenting unique symptoms based on its location:

Cervical (neck): Cervical facet joint OA affects the upper part of the spine, typically causing neck stiffness, pain, and sometimes headaches or discomfort radiating into the shoulders and arms.
Thoracic (mid-back): Thoracic OA is less common but can cause upper and mid-back pain. It may also contribute to limited mobility and discomfort when twisting or bending.
Lumbar (lower back): The most common form, lumbar facet joint OA, leads to lower back pain, especially when standing or walking. Pain may radiate into the hips, buttocks, or thighs and often worsens with prolonged activity.

Recognizing The Signs And Symptoms

Facet joint OA often causes localized pain and stiffness, which can vary depending on where in the spine it occurs. Here’s how symptoms typically present in each spinal region.

Joint Discomfort

Joint discomfort may stem from inflammation, wear, or injury, causing stiffness and limited mobility.

Radiating Nerve Pain

Radiating nerve pain from compression or damage may cause tingling, weakness, or numbness in the limbs.

Pain With Movement

Pain with movement may stem from joint, nerve, or muscle issues, making activity more difficult.

Localized Pain

Localized pain in one area may result from injury, inflammation, or nerve issues, impacting movement.

Chronic Back Pain

Chronic back pain may result from degeneration, nerve issues, or strain, impacting posture and mobility.

Lower Back Pain

Lower back pain may arise from strain, disc issues, or nerve compression, often limiting movement.

Crepitus

Crepitus is a grinding or popping in a joint, often linked to cartilage wear, arthritis, or instability.

Joint Deformity

Joint deformity may result from arthritis, injury, or congenital issues, causing pain and limited function.

Tingling And Numbness

Restricted range of motion may result from stiffness, inflammation, or damage, making movement difficult.

Muscle Weakness

Muscle weakness may stem from nerve, muscle, or joint issues, making movement and activity more difficult.

Muscle Spasms

Muscle spasms are sudden contractions from nerve issues, dehydration, or fatigue, causing pain and stiffness.

Joint Stiffness

Reduced flexibility in joints due to nerve irritation or inflammation.

Difficulty Standing Or Walking

Difficulty standing or walking may result from muscle, joint, or nerve issues, affecting daily mobility.

Restricted Range Of Motion

Difficulty moving the neck, back, or affected limbs due to pain or stiffness.

What Causes Joint Osteoarthritis To Develop?

Facet joint OA usually develops over time due to a combination of lifestyle, genetic, and physical factors. Here are the main contributors:

Aging: Natural wear and tear over time leads to cartilage breakdown, making aging the most common cause.
Repetitive stress or strain: Jobs or activities that involve repeated spine movements can accelerate joint degeneration.
Injury or trauma: Accidents or spinal injuries can damage facet joints, increasing the risk of early-onset OA.
Genetics: Having a family history of OA can make individuals more susceptible to the condition.
Obesity: Excess weight puts added pressure on the spine, especially the lower back, speeding up joint wear.
Poor posture: Prolonged slouching or misalignment strains the facet joints, contributing to degeneration over time.
Previous spinal surgery: Surgery can alter spine mechanics, potentially increasing stress on nearby facet joints.
Sedentary lifestyle: Lack of movement weakens supporting muscles, leading to poor joint support and stiffness.
Inflammatory joint disease: Conditions like rheumatoid arthritis can cause joint inflammation, damaging cartilage in the facet joints.

Diagnosing Osteoarthritis In The Facet Joints

Healthcare providers use a combination of evaluations and tests to diagnose facet joint OA accurately. Here are the key steps in the process:

Review of medical history: Doctors begin by discussing symptoms, past injuries, and overall medical history to assess risk factors and rule out other conditions.
Physical exam: A hands-on evaluation helps identify pain points, check for limited mobility, and assess reflexes to determine how the spine is affected.
Imaging tests: X-rays, MRIs, and CT scans provide detailed views of the spine, revealing joint degeneration, cartilage loss, and other structural damage.

Complications That May Occur If Joint OA Is Left Untreated

When facet joint OA is left untreated, it can lead to a range of serious and progressive complications that significantly affect spinal health and daily life. Over time, persistent inflammation and joint degeneration can cause lasting damage, not just to the joints themselves, but also to the surrounding nerves and muscles.

Chronic pain: Ongoing joint inflammation can result in persistent, unrelenting pain that becomes harder to manage over time.
Spinal instability: As joint damage progresses, the spine can lose its normal alignment, leading to instability and increased risk of injury.
Nerve compression or damage: Degenerated facet joints may press on nearby nerves, causing numbness, tingling, or radiating pain—particularly in the arms or legs.
Decreased mobility and flexibility: Joint stiffness can reduce range of motion, making everyday movements more difficult.
Muscle weakness: Chronic pain and nerve involvement can lead to muscle deconditioning and weakness over time.
Loss of function or disability: In severe cases, individuals may struggle with basic activities such as walking, standing, or bending, limiting independence.
Development of other spinal conditions: Untreated OA may contribute to secondary conditions like spinal stenosis or spondylolisthesis.
Increased risk of falls or accidents: Poor balance, reduced mobility, and nerve-related weakness can raise the likelihood of slips or falls, especially in older adults.
Impaired quality of life: The combination of pain, limited movement, and reduced independence can lead to social withdrawal, depression, and lower overall life satisfaction.

We Provide Evidence-Based Treatments For Facet Joint Osteoarthritis

At Compass Pain and Wellness, we offer a comprehensive, evidence-based approach to treating facet joint OA—designed to relieve pain, restore mobility, and help you return to the activities you love. Our care plans are personalized to fit each patient’s unique condition, lifestyle, and goals. We start with the least invasive methods and progress to more advanced interventions if needed, always keeping your comfort and long-term health at the forefront.

Whether you’re experiencing early symptoms or advanced facet joint degeneration, our goal is to provide relief and improve your quality of life through integrative and multidisciplinary care.

Mindfulness and Meditation

Mindfulness and meditation help manage chronic pain by reducing stress and promoting emotional resilience.

Physical Therapy

Physical therapy improves strength, flexibility, and mobility while addressing pain from injury or chronic conditions.

Massage

Massage therapy eases muscle tension and improves circulation to support pain relief and overall well-being.

Chiropractic Care

Chiropractic care improves spinal alignment and joint function to reduce pain and enhance physical mobility.

Acupuncture

Acupuncture stimulates targeted points on the body to reduce pain, support healing, and restore energy balance.

Medication Therapy

Medication therapy uses tailored prescriptions to reduce chronic pain and improve daily function and comfort.

Trigger Point Injections

Trigger point injections treat muscle knots by relaxing tense tissue and relieving localized pain or stiffness.

Joint Injections

Joint injections deliver medication into affected joints to relieve inflammation and improve range of motion.

Nerve Block

Nerve blocks interrupt pain signals from specific nerves to reduce chronic or procedure-related discomfort.

Peripheral Nerve Stimulation

Peripheral nerve stimulation sends mild electrical signals to disrupt chronic pain from damaged peripheral nerves.

Radiofrequency Ablation

Radiofrequency ablation targets specific nerves to interrupt pain signals and provide lasting pain relief.

Spinal Cord Stimulation

Spinal cord stimulation delivers electrical pulses to block nerve pain and reduce discomfort in the back or limbs.

At Compass Pain and Wellness, you’re not just receiving treatment—you’re gaining a dedicated care team focused on helping you live with less pain and more freedom.

Associated Injuries Linked To Facet Joint OA

Facet joint OA rarely exists in isolation. It often develops alongside or contributes to other spinal conditions that can intensify pain and limit function. These overlapping conditions can create a cycle of discomfort, making diagnosis and treatment more complex. Understanding these related injuries is essential for managing the full scope of a patient’s symptoms.

Our Providers

Meet our experienced and compassionate team of doctors who specialize in helping you manage your condition. With a patient-centered approach, our doctors work to understand your unique needs and provide compassionate, personalized care. Trust our providers to guide you on your journey to better health and improved well-being.

Dr. Kristi Reed, MD

Dr. Randolph Cribbs, MD

Dr. Carl Balog, MD

References

Perolat, R., Kastler, A., Nicot, B., Pellat, J. M., Tahon, F., Attye, A., Heck, O., Boubagra, K., Grand, S., & Krainik, A. (2018, September 8). Facet joint syndrome: From diagnosis to interventional management. PubMed Central. https://pmc.ncbi.nlm.nih.gov/articles/PMC6206372/

Relief from facet joint osteoarthritis is within reach. Contact Compass Pain today to schedule your consultation and take the first step toward a pain-free life.

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