About facet joint pain
Each level of the spine has two small facet joints at the back that guide and limit movement. Like other joints, they have cartilage and a lining that can wear and become inflamed with age, old injuries, or repeated strain.
Facet pain usually stays in the neck or back, though it can spread into the shoulders, upper back, buttocks, or thighs. Unlike a pinched nerve, it rarely causes numbness or pain below the knee or elbow.
Common symptoms
- Aching pain on one or both sides of the spine
- Pain that worsens with bending backward, twisting, or looking over the shoulder
- Stiffness in the morning or after sitting or standing still
- Pain that spreads into the buttock, thigh, shoulder, or base of the skull but not below the knee or elbow
- Tenderness over the joints beside the spine
Common causes and risk factors
- Age-related wear and arthritis of the facet joints
- Disc wear that shifts more load onto the facets
- Whiplash or other past injuries to the neck or back
- Repetitive extension and rotation in sports such as golf, gymnastics, and rowing
How we diagnose it
Dr. Chen examines how movement, posture, and pressure over the joints affect your pain, and checks nerve function to rule out a pinched nerve. X-ray or MRI can show facet arthritis, but many people have arthritis on imaging without pain, so imaging alone does not prove the source. The most reliable test is a diagnostic medial branch block, in which a small amount of numbing medicine is placed on the tiny nerves that carry pain from the joint to see whether your usual pain eases.
How Propel treats facet joint pain
We start with a progressive strength and mobility program focused on the trunk, hips, and upper back, along with adjustments to training and daily load so you can stay active. Short-term medication and heat can help during flares.
If pain persists, Dr. Chen may perform facet joint injections or medial branch blocks under image guidance. When those blocks clearly help, nerve ablation uses controlled heat to quiet the same small nerves, which can provide relief that lasts much longer than an injection and makes it easier to keep up with exercise.
What to expect at your visit
- 1.
We listen first
Your visit opens with a real conversation: how the problem started, what you have already tried, and the activity you want back.
- 2.
Exam and in-office ultrasound
A hands-on exam, then ultrasound at the exam table, often while you move, so your physician can see the tendon, joint, or nerve involved.
- 3.
A clear diagnosis and plan
You leave knowing what is wrong and what your options are, from strength-based rehab to procedures, and why we recommend each one.
- 4.
Treatment and follow-through
Most procedures happen here in the office. We coordinate with your physical therapist and check progress against the goals you set.
Questions about facet joint pain
- What is the difference between a facet injection and nerve ablation?
- A facet injection or medial branch block places numbing medicine, sometimes with a steroid, near the joint or its nerves, and relief is usually temporary. Nerve ablation uses heat to quiet those nerves so they stop sending pain signals for a longer period. The block usually comes first to confirm that the facets are the true source.
- Does nerve ablation last forever?
- No. The treated nerves slowly regrow, so relief typically lasts many months and sometimes longer, then pain may return. The procedure can often be repeated if it helped the first time.
- Is it best to avoid bending backward with facet pain?
- You may need to limit painful positions for a short time, but the long-term goal is to keep moving, not to build a list of things to avoid. A gradual strength program usually lets people return to the movements and sports they enjoy.