Is Your Back Pain Coming from Your Facet Joints?
H2 SUBHEADING IN THE FORM OF A QUESTION
Do you get pain in your lower back when you bend backward, twist, or stand for too long?
Maybe you feel stiff in the morning, or your back “locks up” during certain movements. That could be facet joint arthritis (also called facet arthropathy), a common—but often overlooked—source of chronic low back pain.
What Is Lumbar Facet Arthritis?
The facet joints are small joints located along the back of your spine. They act like hinges—guiding movement, providing stability, and allowing your vertebrae to glide smoothly against each other. Over time, just like other joints in the body, the facet joints can wear down
(degenerate). Their cartilage may thin or break down, inflammation can develop, and small bone spurs may form.
Weakness or instability in the supporting spinal ligaments and muscles can accelerate this process. It’s especially common as we age, and is often seen in patients with degenerative disc disease. When a spinal disc loses height, it places extra stress on the facet joints, speeding up their degeneration and leading to chronic pain and stiffness. This process is known as facet arthritis or facet arthropathy.
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Why Does Facet Joint Arthritis Hurt So Much?
- Cartilage breakdown and joint inflammation
As the smooth cartilage that cushions the facet joints wears away, the joint surfaces begin to rub directly against each other. This friction triggers inflammation, leading to localized back pain, stiffness, and muscle tension. - Joint swelling and bone spurs
Over time, the irritated joints may thicken and swell. The body may respond by forming small bony overgrowths (osteophytes), which can further limit motion and irritate nearby nerves and soft tissues—causing even greater stiffness and discomfort. - Motion stress and spinal instability
When the facet joints and surrounding stabilizing structures (ligaments and muscles) weaken, the spine becomes less stable. Everyday movements—bending, twisting, or even prolonged sitting—can place abnormal stress on already painful tissues. - Nerve sensitivity within the joint capsule
Facet joints are richly supplied with sensory nerves. When the joint becomes inflamed, these nerves become hypersensitive, meaning even small movements can trigger sharp or aching pain that radiates into the surrounding muscles.
Common Symptoms of Lumbar Facet Arthritis
- Localized low back pain, often one side or both, usually deeper in the spine
- Pain worsens with extension (leaning back), twisting, and standing
- Morning stiffness or “locked” feeling when getting up
- Pain relief when bending forward or sitting (unloading the facet joints)
- Referred pain to the buttock, hip, or thigh (rarely down the full leg)
- Muscle spasms and stiffness around the lower back
Diagnosing Facet Joint Arthritis
Facet arthritis diagnosis uses a combination of:
- Patient history & physical exam
Your spine specialist asks about pain triggers (extension, twisting) and performs tests (e.g., extension-rotation maneuvers) to provoke facet pain. - Imaging
o Spinal X-ray, CT or MRI can show joint degeneration, narrowing, osteophytes
o Imaging alone is rarely conclusive, since many people have facet degeneration on scans without symptoms - Sometimes diagnostic facet joint injections are used
A small amount of anesthetic or prolotherapy solution can be injected into the facet joint or surrounding tissues. If your pain is dramatically reduced, this can support that the facet joint as a pain source.
Treatment Options for Lumbar Facet Arthritis
Why Conventional Treatments Often Fall Short
Traditional pain management options such as steroid injections and radiofrequency ablations (RFA) can provide temporary relief, but they do not address the root cause of the problem—spinal instability and degeneration. Repeated steroid injections may actually weaken
the supporting ligaments and muscles, leading to further spinal degeneration. Steroid injections can also lead to systemic side effects such as elevated blood sugar, muscle loss, and bone thinning (osteoporosis).
Radiofrequency ablations may temporarily numb the pain but can also damage sensory nerves that help stabilize spinal movement, potentially leading to greater long-term instability and spinal degeneration.
Regenerative Medicine: Healing and Stabilizing the Spine
At Integrative Rehab Medicine in Estero, Florida, we specialize in regenerative treatments of the spine that promote true healing and spinal stability—not just temporary pain masking.
These treatments work by strengthening the supporting structures of the spine and stimulating natural tissue repair without the harmful side effects of steroids and nerve burning procedures.
Best Treatment Options for Facet Arthritis Pain:
Prolotherapy: involves the injection of a dextrose solution that stimulates the body’s healing response, helping to tighten and strengthen loose ligaments that stabilize the spine. Strengthening these ligaments can reduce abnormal motion and mechanical stress on the facet joints, leading to long-term improvement in pain and function.
Platelet-Rich Plasma (PRP): uses your own concentrated platelets and growth factors to repair soft tissues, reduce inflammation, and improve muscle and ligament health. In patients with facet joint pain, PRP can enhance stability, promote joint regeneration, and support stronger spinal musculature.
We discussed this evidence in our blog post, Study Shows PRP is an Effective Treatment for Arthritis of the Lumbar Spine, which reviews data demonstrating long-term improvement without the side effects of steroid injections.
Stem Cell Therapy (Bone Marrow Concentrate): For more advanced cases, stem cell–based treatments can enhance regeneration of joint tissues, decrease inflammation, and support long-term structural improvement. These procedures use your body’s own healing cells to restore spinal integrity and mobility naturally.
Comprehensive Healing: Beyond Injections
Regenerative treatments are most effective when combined with a targeted physical therapy program that focuses on improving spinal strength, flexibility, and controlled mobility.
Additional lifestyle strategies play a crucial role in reducing inflammation and maintaining spine health:
- Weight loss to reduce mechanical stress on the spine
- Smoking cessation to improve circulation and healing
- Anti-inflammatory nutrition emphasizing whole, nutrient-dense foods to support joint and muscle recovery
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Frequently Asked Questions
Yes. Arthritis can develop in any joint of the body, including the spine. In the lower back, the lumbar facet joints connect the vertebrae and allow movement. Over time, these joints experience wear and tear from everyday activities, leading to facet joint arthritis—a common cause of chronic back pain and stiffness.
The most common cause of lumbar facet arthritis is the natural aging process. As we get older, the facet joints are repeatedly stressed by bending, twisting, and lifting, which causes gradual degeneration. Other factors that can accelerate this process include repetitive or heavy extension movements, spinal injuries or muscle weakness, obesity and poor posture, and smoking or an unhealthy diet that increases inflammation.
That is why treatments like prolotherapy and PRP, which improve the health and stability of the joint cartilage and supporting ligaments, can provide long-term relief and help slow or even reverse the progression of spinal arthritis.
Facet arthritis typically causes deep, aching back pain and stiffness that are often worse after waking up, standing for long periods, or sitting too long. The pain may radiate into the buttocks or hips but usually does not travel past the knee. Muscle tightness or spasms are also common when the facet joints are inflamed
Yes, it can. While facet joint pain usually stays in the back or buttocks, it may refer pain into the thigh or leg, though not typically below the knee. If the inflamed joint irritates a nearby spinal nerve, it can cause sciatic-type pain, numbness, or tingling down the leg.
Pain from facet arthritis often worsens with standing, bending backward, or twisting. It may improve when sitting or lying down, as this relieves pressure on the joints. Common aggravating factors include poor posture or weak core muscles, high-impact activities such as running or heavy lifting, obesity, inflammatory diets, and smoking, which reduces blood flow and joint healing.
Yes. Lumbar facet arthritis is very common, especially among older adults. It can also affect younger individuals who have had spinal injuries that weaken the ligaments supporting the spine. When the ligaments lose tension, the spine becomes unstable, placing more stress on the facet joints. Over time, this leads to joint degeneration and arthritis.
Yes. Lumbar facet arthritis is essentially spinal osteoarthritis, also known as spondylosis. It specifically refers to wear and tear of the facet joints, which sit at the back of the spine and help control movement. As these joints degenerate, they may develop bone spurs and lose protective cartilage, leading to stiffness, inflammation, and pain.
Exercises that strengthen and stabilize the spine are key for long-term relief. Focus on core strengthening, especially abdominal muscles, as well as low-impact aerobic activities such as walking or swimming, and gentle stretching to maintain flexibility. Avoid excessive back extension, heavy lifting, or twisting, which can irritate the facet joints.
Treatments like prolotherapy and PRP injections can also enhance the stability of the supporting ligaments, helping exercise programs be more effective over time.
Steroid injections can provide short-term relief by reducing inflammation around the facet joints. However, repeated steroid use has important drawbacks. It can weaken or damage cartilage, ligaments, and surrounding tissue; cause muscle atrophy; and accelerate joint degeneration. Steroids can also raise blood sugar levels and affect bone health.
Regenerative treatments such as PRP or cell-based injections are often preferred because they aim to heal and strengthen tissues rather than break them down.
Radiofrequency ablation, or RFA, uses heat to temporarily disable the small nerves that send pain signals from the facet joints. It can provide relief for four to six months, but the nerves eventually regenerate. While generally safe, repeated RFA can sometimes lead to weakness or atrophy of the paraspinal muscles that support the spine because those same nerves also help control muscle tone.
For patients seeking longer-term improvement, regenerative treatments such as PRP, prolotherapy or stem cells can help restore spinal stability and function naturally.
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Why Choose Integrative Rehab Medicine for Non-surgical Treatment of Lumbar Lacet Arthritis
At Integrative Rehab Medicine in Estero, Florida, we take a comprehensive, evidence-based approach to treating lumbar facet arthritis and other causes of chronic back pain. Our goal is not just to relieve pain temporarily, but to restore function, stability, and long-term spine health.
Our patients choose us because we offer:
- Highly trained spine and regenerative medicine specialists
Our physicians are nationally recognized leaders in regenerative orthopedics and spinal interventions. Each treatment is carefully planned and performed by experienced specialists who focus exclusively on non-surgical spine care. - In-house biologics laboratory for superior quality PRP and stem cell preparations
Every sample is processed on-site in our advanced lab to ensure the highest concentration and purity of platelets or regenerative cells, providing the best possible outcomes for healing and tissue repair. - Precise image-guided procedures
All injections are performed under fluoroscopy and/or ultrasound guidance to ensure accuracy, safety, and maximum effectiveness. We target not only the painful joint, but also the supporting ligaments and surrounding structures that contribute to spinal stability. - Integrated care model combining rehabilitation and nutrition
True recovery requires more than an injection. We design personalized rehabilitation programs to strengthen the spine and improve controlled mobility, while our team provides guidance on anti-inflammatory nutrition and lifestyle changes to support long-term results.
Integrative Rehab Medicine represents the leading edge of regenerative spine care in Southwest Florida. If you’re ready to move beyond short-term pain management and start restoring your spine’s natural health, our team is here to help you get there safely and effectively.
