FAQs on Facet Syndrome (Spinal Arthritis)  Treatment at Phoenix Pain Clinics                       

Back pain occurs in the general population at a prevalence rate of 55-80%. Lumbar facet joint pain can lead to chronic low back pain. Facet joint syndrome affects the vertebrae of the spine and causes loss of flexibility.

What is a facet joint?

The facet is a small joint that is between each vertebra along the spinal column. The facet joints are in constant motion, as they provide the spine with flexibility and stability necessary to bend, walk, sit, and twist. The joint surfaces are lined with cartilage, which allows them to slide easily over the other. Joints are often damaged from injury or due to wear and tear arthritis.

What are the symptoms of facet syndrome?

The pain associated with facet joint syndrome is worse at the beginning and end of the day. In addition, facet joint symptoms flare up during weather changes. In addition, this condition causes abnormal curvature of the spine, bone crepitus (cracking), and increased pain with prolonged standing or sitting.

What are the risk factors for spinal arthritis?

Family history of arthritis or back problems

Advancing age

Overuse or heavy labor

Presence of arthritic diseases, such as arthritis or gout

Damage from injuries, such as a car accident or whiplash

How is facet joint syndrome diagnosed?

To diagnose facet joint syndrome, the doctor will examine your back, conduct a neurological examination, and take a medical history. Certain diagnostic tests are used for the diagnosis, such as x-rays and a magnetic resonance imaging (MRI) scan. A facet joint block is often used to confirm the diagnosis, which involves injecting a long-acting anesthetic onto the nerves that are associated with pain. If pain relief occurs, the doctor confirms a diagnosis of facet joint syndrome.

How is facet joint syndrome treated?

The treatment of facet joint syndrome depends on the severity of the pain and the condition. Options include:

Facet joint injection (FJI) – This procedure involves injection of a corticosteroid into the facet joint to relieve inflammation. A recent study showed that FJI had moderate evidence for improving pain associated with spinal arthritis.


Prolotherapy – With this procedure, a solution of concentrated dextrose and a local anesthetic is injected into the damaged tissue. This encourages new growth and stimulates the body’s natural ability to repair damaged tissue.


Platelet-rich plasma (PRP) therapy – This procedure involves use of platelets to initiate tissue repair. Platelets contain growth factors that start the healing process by attracting stem cells. PRP involves injecting the patient’s own blood into the damaged area.


Physical therapy – To improve circulation, strength, and flexibility, the therapist will teach you specific exercises. To manage pain, special modalities include ultrasound, heat/cold therapy, electrical stimulation, and massage.


Medications – The pain specialist will first prescribe prescription-strength nonsteroidal anti-inflammatory drugs (NSAIDs), such as ketoprofen and naproxen sodium. For serious pain, analgesics are used. Muscle relaxants are reserved for muscles spasms associated with facet joint syndrome.


Epidural steroid injection (ESI) – The doctor uses x-ray guidance to inject the epidural space with a corticosteroid. Sometimes, a long-acting anesthetic is used for added benefit. Studies show that this procedure has an 80-90% efficacy rate.


Radiofrequency ablation (RFA) – With this procedure, a special needle with probe is injected into the spine. The probe emits radiofrequency energy on the nerves to inactivated them.


Medial branch block – The doctor uses a long-acting anesthetic onto the nerves near the facet joints. Sometimes, a neurolytic agent is used for long-lasting results. A 2007 clinical study found that this procedure had a 70% success rate.