Facet joints are the small paired joints at the back of every spinal segment that guide motion. When they become arthritic, irritated, or injured, they generate a distinct pattern of dull, achy spinal pain that worsens with extension (leaning back) and rotation. Treatment ranges from chiropractic and PT to highly targeted interventional procedures like medial branch blocks and radiofrequency ablation.
Also known as: Facet syndrome, Facet arthropathy, Zygapophyseal joint pain
Symptoms of facet pain
- Localized neck or low back pain that worsens leaning backward
- Pain with twisting or standing for long periods
- Stiffness that's worst in the morning and after rest
- Referred pain into the buttock, thigh, or shoulder (rarely below the knee or elbow)
- Tenderness directly over the spine
Common causes
- Age-related facet joint arthritis
- Whiplash or other auto accident injury
- Repetitive extension activities (overhead work, gymnastics)
- Adjacent disc degeneration that overloads the facets
- Spondylolisthesis
How we treat facet pain
We combine multiple disciplines under one roof so you get the right care for your case — not just whatever one provider happens to offer.
Chiropractic care
Specific adjustments to restore facet motion and reduce inflammation.
Learn more →Physical therapy
Core and posterior chain strengthening to reduce facet loading.
Learn more →Medial branch blocks & RFA
Diagnostic medial branch blocks confirm facet pain, then radiofrequency ablation provides 6–18 months of relief.
Learn more →Pain management
Multi-modal pain plan combining injections with rehabilitation for sustained results.
Learn more →What to expect on your first visit
- Targeted exam — extension/rotation testing and palpation over the facet joints
- Imaging review for facet hypertrophy or arthritis
- Trial of chiropractic + PT for 4–6 weeks if appropriate
- Diagnostic medial branch blocks if conservative care doesn't resolve symptoms
- Radiofrequency ablation for confirmed facet-mediated pain
Frequently asked questions
How do I know if my pain is from facet joints?
Classic facet pain worsens with leaning backward, twisting, or standing — and improves with sitting forward. Diagnostic medial branch blocks can confirm the diagnosis with high accuracy.
How long does radiofrequency ablation last?
Typical relief lasts 6–18 months. The treated nerves regenerate over time, and the procedure can be repeated as needed.
Can chiropractic alone fix facet pain?
For mild, recent-onset facet pain, often yes. For chronic or arthritic facets, the best long-term outcomes combine chiropractic, PT, and (when needed) interventional procedures.
Ready to start treatment?
Same-day appointments available. We accept most major insurance, workers' comp, and personal injury liens.
Related conditions we treat
Other spine and musculoskeletal conditions commonly seen alongside facet pain.
SI Joint Dysfunction
The sacroiliac (SI) joints connect your sacrum to your pelvis on each side. They have very limited motion but absorb tremendous load with every step. When an SI joint becomes inflamed, hypermobile, or hypomobile, it produces a distinctive pattern of pain in the low back, buttock, hip, or even down the leg — frequently misdiagnosed as lumbar disc or sciatica problems.
Learn more →Whiplash
Whiplash is a soft-tissue neck injury caused when the head is rapidly snapped backward and then forward — most commonly in rear-end auto accidents. The sudden force overstretches cervical muscles, ligaments, and facet joints, and can also irritate or injure cervical discs. Symptoms often appear hours or days after the crash, which is why same-day documentation matters for both your recovery and any personal injury claim.
Learn more →Sciatica
Sciatica is pain that radiates along the path of the sciatic nerve — from the lower back, through the buttock, and down one leg. It's almost always caused by compression or irritation of a lumbar nerve root, most often from a herniated disc, spinal stenosis, or facet arthritis. The good news: the vast majority of sciatica cases resolve without surgery when treated early with the right combination of decompression, manual therapy, and rehab.
Learn more →