Facet Joint Pain

There are a pair of facet joints, which are small joints at the back of the spinal canal. They are found throughout the length of the spine and therefore are present in the cervical, thoracic and lumbar spine. With the disc, they allow movement and provide some stability to the spine. The facet joint is like a hip or knee joint and can undergo arthritic change. As the disc narrows between the vertebrae, the facet joints will also wear and can give rise to a grating or clicking sensation as well as pain. Stiffness can be an early symptom and can give rise to back pain which is worse when standing and leaning backwards. Cervical facet joint pain can radiate into the shoulder area as well as up to the back of the head and can be associated with a headache. Stiffness and muscle tenderness are common.
Thoracic facet joint pain can localise to the levels of the shoulder blades and occasionally below this. Lumbar facet joint pain can radiate into the buttocks, hips and also into the thigh area. Most patients will have some tenderness overlying the facet joints and the pain can be aggravated by leaning backwards and/or twisting of the neck and lower back and tends to be improved by bending forwards. Rarely the arthritis from the facet joint can cause a cyst/ganglion which can pinch on a nerve giving leg/arm pain or can give rise to spinal stenosis, again resulting in arm or leg symptoms.