That deep ache in your back when you bend or twist.
The facet joints are the small paired joints that link each vertebra to the one above and below it. They guide movement and bear load — and like any joint, they can become worn, inflamed, and painful. Facet joint pain is one of the most common and most treatable causes of chronic lower back and neck pain.
Your doctor may call this facet syndrome or facet arthropathy.
Often seen within a few days — sometimes as soon as tomorrowRequest your first visit
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What facet joint pain really is.
Each vertebra has two pairs of facet joints — one set connecting to the vertebra above, one to the vertebra below. They're covered in cartilage and surrounded by a fluid-filled capsule, just like a knee or hip joint. Their job is to control the direction and range of spinal movement while sharing the load with the discs. When the cartilage wears down or the capsule becomes inflamed, the joint becomes a source of pain.
Facet joint pain tends to be worst with extension (leaning backward), rotation (twisting), and prolonged standing. It often eases with sitting or bending slightly forward, which takes load off the joints. The pain is usually local — a deep ache in the lower back or neck near the spine — though it can spread into the buttock, hip, or shoulder in a referred pattern. It rarely travels below the knee the way disc-related nerve pain does.
The good news
Facet joint pain is one of the more straightforward pain generators to identify and treat. Diagnostic medial branch blocks can confirm the source, and if they do, radiofrequency ablation — a minimally invasive procedure that interrupts the pain signal — can provide relief lasting a year or more in many patients.
Medial branch blocks as diagnosis and treatment
The facet joints are innervated by medial branch nerves. A positive response to a diagnostic medial branch block — significant pain relief for the duration of the local anesthetic — confirms the facet joint as the pain source. This sets up radiofrequency ablation (RFA) as the next step: a precisely targeted procedure that thermally disrupts the medial branches, interrupting the pain signal for an extended period. RFA is one of the higher-yield interventional procedures in spine pain management.
Common signs we treat.
Pain when bending backward
Leaning back or extending the spine increases load on the facet joints — this position reliably worsens facet-related pain.
Morning stiffness
Pronounced stiffness in the back or neck on waking, which typically loosens up after moving around for 20–30 minutes.
Localized pain near the spine
A deep ache that sits right alongside the spine — sometimes spreading into the buttock or hip but rarely past the knee.
From hurting to healed.
We work from the least-invasive options upward, escalating only if you need it. Most patients improve well before surgery is ever discussed.
Diagnose the cause
A physician examines you and, if needed, reviews imaging to pinpoint exactly what's driving the pain.
Calm it down
Targeted physical therapy, activity guidance, and medication to settle the irritation and reduce inflammation.
Image-guided injections
If pain persists, a precisely targeted injection delivered to the source under imaging.
Advanced options
For the few who need more, minimally invasive interventional procedures — with surgery as a last resort.
Treatment is matched to your specific diagnosis at your visit. The options shown reflect NASPAC's general approach and should be confirmed against the practice's verified procedure list.
Still have questions?
They're the small paired joints at the back of each spinal level — you have two at every level from your neck to your tailbone. They guide how your spine bends and rotates while sharing load with the discs. Over time, like any joint, they can wear, develop arthritis, or become acutely inflamed.
A physician can often suspect facet joint pain from the pattern of symptoms and a physical exam — particularly if the pain is worse with extension and rotation, and located close to the spine without radiating below the knee. Confirmation comes from a diagnostic medial branch block: if numbing the nerve that serves the joint substantially relieves your pain, the facet joint is the source.
A medial branch block is a precise, image-guided injection of local anesthetic near the small nerves that carry pain signals from the facet joints. It's used both to confirm the diagnosis and, in some cases, to provide temporary relief. If the block gives significant relief, it predicts a strong response to radiofrequency ablation, which can extend that relief for many months.
The underlying joint wear doesn't reverse, but the pain can be brought under very good control. Physical therapy helps reduce the load on the joints; medial branch blocks and radiofrequency ablation address the pain signal directly. Many patients go extended periods — often a year or more after RFA — with minimal symptoms, and can repeat the procedure as needed.
Stop living with the joint pain.
Book with a board-certified pain physician near you — most patients are seen within days.
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