Facet Joint Syndrome
Facet joint syndrome (zygapophyseal joint syndrome) is pain arising from the facet joints of the spine due to degenerative changes, injury, or inflammation. It is a common cause of chronic spinal pain and is diagnosed clinically and confirmed with diagnostic medial branch blocks.
Symptoms
- Localized spinal pain, often aching or stiff
- Pain with extension and rotation
- Referred pain to buttocks, hips, or shoulders (not below the knee)
- Stiffness, especially in the morning
- Pain worsened by prolonged standing or extension
- No neurological deficit typically
Causes
- Degenerative joint disease (osteoarthritis)
- Trauma / whiplash injury
- Repetitive loading / occupational stress
- Post-surgical adjacent segment disease
- Inflammatory arthropathy
Diagnosis
Accurate diagnosis is essential for effective treatment. Clinicians typically use a combination of:
- Clinical examination — pain with extension and rotation
- Diagnostic medial branch block (gold standard confirmation)
- X-ray, MRI for degenerative changes
- Bone scan or SPECT for active inflammation
Treatment Approaches
Related Procedures
Radiofrequency Ablation (RFA)
Radiofrequency ablation uses electrical current generated by radio waves to heat and destroy specific nerve fibers that transmit pain signals. Under fluoroscopic guidance, a needle electrode is precisely positioned near the target nerve, and controlled thermal energy creates a lesion that interrupts pain transmission.
Medial Branch Block
A medial branch block is both a diagnostic and therapeutic procedure that involves injecting local anesthetic onto the medial branch nerves that innervate the facet joints. If the patient experiences significant pain relief, it confirms the facet joint as the pain source and supports consideration of radiofrequency ablation.
🚨 Red Flags
Seek urgent medical evaluation if you experience any of the following:
- ⚠️ Progressive neurological deficit
- ⚠️ Unremitting pain not responding to any treatment
- ⚠️ Constitutional symptoms (fever, weight loss)
Frequently Asked Questions
Related Conditions
Sciatica
Sciatica refers to pain that radiates along the path of the sciatic nerve, from the lower back through the hips and buttocks and down the leg. It typically affects one side of the body and is caused by compression of the sciatic nerve roots (L4-S3), most commonly from a lumbar disc herniation or foraminal stenosis.
Lumbar Spinal Stenosis
Lumbar spinal stenosis (LSS) is a narrowing of the spinal canal, lateral recesses, or neural foramina in the lumbar spine that results in compression of neural structures. It is the most common reason for spinal surgery in adults over 65 and is typically caused by degenerative changes including disc bulging, facet joint hypertrophy, and ligamentum flavum thickening.
You May Also Want to Understand
Sciatica
Sciatica refers to pain that radiates along the path of the sciatic nerve, from the lower back through the hips and buttocks and down the leg. It typically affects one side of the body and is caused by compression of the sciatic nerve roots (L4-S3), most commonly from a lumbar disc herniation or foraminal stenosis.
Lumbar Spinal Stenosis
Lumbar spinal stenosis (LSS) is a narrowing of the spinal canal, lateral recesses, or neural foramina in the lumbar spine that results in compression of neural structures. It is the most common reason for spinal surgery in adults over 65 and is typically caused by degenerative changes including disc bulging, facet joint hypertrophy, and ligamentum flavum thickening.
Cervical Radiculopathy
Cervical radiculopathy is pain, numbness, or weakness caused by compression or irritation of a cervical nerve root. It most commonly results from disc herniation or foraminal stenosis and typically affects the C6 or C7 nerve roots.
Sacroiliac Joint Dysfunction
Sacroiliac (SI) joint dysfunction refers to pain originating from the sacroiliac joint complex, a common but often underdiagnosed cause of low back and buttock pain. The SI joint transmits forces between the spine and lower extremities and can become painful through inflammatory, degenerative, or traumatic mechanisms.
Dr. Shahnawaz F Shah
Interventional Spine & Pain Physician
Dr. Shah specializes in the diagnosis and management of facet joint syndrome using evidence-based approaches tailored to each patient's needs.
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