What is Spine Joint Pain?
Spine joint pain, often called facet joint arthritis or spinal osteoarthritis, occurs when the cartilage in the small joints of your spine breaks down over time. These facet joints connect the vertebrae and allow your spine to bend, twist, and flex. When they degenerate, movement becomes painful and restricted.
Your spine contains 33 vertebrae with numerous facet joints throughout. These joints can develop arthritis in any region:
- Cervical spine (neck) - 7 vertebrae
- Thoracic spine (mid-back) - 12 vertebrae
- Lumbar spine (lower back) - 5 vertebrae
- Sacral spine (base) - 5 fused vertebrae
Lower back (lumbar) facet joint arthritis is most common, followed by neck (cervical) involvement. Over 80% of adults show evidence of spinal degeneration by age 80, though not all experience symptoms.
Understanding Facet Joint Arthritis
Facet joints are paired joints located at the back of each spinal segment. They’re covered with smooth cartilage and surrounded by a joint capsule containing lubricating fluid, similar to other joints in your body.
As we age, this cartilage can wear down due to:
- Natural aging and repeated use over decades
- Joint stress from poor posture or body mechanics
- Previous injuries that accelerated degeneration
- Excess weight increasing load on spinal joints
- Genetic factors affecting cartilage quality
Symptoms to Watch For
Symptoms vary depending on which area of the spine is affected.
Lower Back (Lumbar) Facet Joint Pain
- Localized pain in the lower back
- Pain radiating to buttocks, hips, or upper thighs
- Worsens with standing or arching backward
- Improves when sitting or bending forward
- Morning stiffness lasting 30+ minutes
Neck (Cervical) Facet Joint Pain
- Neck pain and stiffness
- Headaches originating at the base of the skull
- Pain radiating to shoulders or upper back
- Difficulty turning your head side to side
- Pain when looking up or extending neck backward
When to See a Doctor
Consult a healthcare provider if you experience:
- Back or neck pain lasting more than 2 weeks
- Pain that doesn’t improve with rest or over-the-counter medications
- Progressive worsening of symptoms
- Pain that interferes with daily activities or sleep
- Numbness, tingling, or weakness in arms or legs (may indicate nerve involvement)
- Loss of bladder or bowel control (seek immediate care)
Treatment Options
Conservative Treatments
- Physical therapy to strengthen core and back muscles
- Posture training and body mechanics education
- Low-impact exercise like swimming, walking, or cycling
- Heat and cold therapy for pain relief
- Over-the-counter medications (acetaminophen, NSAIDs)
- Weight management to reduce spinal load
Medical Interventions
- Facet joint injections: Corticosteroids to reduce inflammation and pain
- Medial branch blocks: Target nerves supplying facet joints
- Prescription medications: Muscle relaxants, anti-inflammatories
- Radiofrequency ablation: Heat treatment to interrupt pain signals
Managing Spine Joint Pain Daily
- Practice proper lifting techniques (bend knees, not back)
- Maintain good posture when sitting and standing
- Take frequent breaks from prolonged positions
- Sleep on a supportive mattress with proper pillow height
- Maintain healthy weight to reduce joint stress
Questions to Ask Your Healthcare Provider
- Is my spine pain coming from facet joints or another source?
- What stage of degeneration do my imaging studies show?
- Which conservative treatments should I try first?
- Am I a candidate for facet joint injections?
- What can I do to prevent progression?
- Should I see a physical therapist or pain specialist?