What Is Facet Arthrosis?

Medically Reviewed by David Zelman, MD on June 30, 2023
4 min read

Minor lower back pain is fairly common among adults. But severe, constant pain in the back can happen, especially as you get older. Facet arthrosis is a condition that may affect older adults and people who have suffered injury or trauma to their back.

Facet arthrosis can be a painful condition and affect your quality of life. But there are ways to help manage and treat it.

The facets are joints in the back (posterior) portion of your spine. They help to balance your spine and make sure it’s properly aligned. Facets run alongside the vertebrae of your spine and help you with certain motions, like twisting and turning. They’re essential for the proper function of your back.

Normally, there’s cartilage and capsules containing fluid attached to the facets that provide padding and lubrication against other spinal joints. When this cartilage wears down over time or becomes damaged, the facet joints may rub against other spinal bones or joints. This can cause discomfort or even extreme pain in the back and other areas of your body.

Facet arthrosis often affects people who are older as the result of wear-and-tear on the facet joints. It can also be caused by:

  • Arthritis of the facet joint
  • Repetitive stress on the joint
  • Osteoarthritis
  • Trauma to the area caused by impact injury, such as a car accident
  • Microtraumas to the area
  • Obesity
  • Poor body mechanics, such as bad posture

Pain in the lower back can stem from a number of causes. You can differentiate facet arthrosis from other causes of lower back pain by watching for these symptoms:

  • Lower back pain that is worse in the morning
  • Pain that increases during times of inactivity
  • Pain during spinal flexion or while performing a twisting motion
  • Pain that usually stays in one place, but can radiate to other areas of the body

Facet arthrosis is a condition that usually doesn’t go away. It may stay with you in some form for life. But you can help manage the pain or discomfort by using topical treatment methods or undergoing certain procedures.

Facet arthrosis is a progressive disease. It can get worse if you don’t take steps to manage it, and other complications can also arise. Leading a healthy, active lifestyle can help you manage the disease and avoid its progression.

Some complications may happen if the disease has progressed far enough.

Bone spurs. When your cartilage and fluid-filled capsules wear down as a result of facet arthrosis, your bones can start touching directly. They can rub together, which may be very painful. This can cause a condition known as bone spurs. The outer parts of your bones are normally smooth because they are protected by cartilage. When you have bone spurs, the bones become rough in the places where they rub together. This in itself doesn’t usually cause pain, but it can be painful if the spurs reach a nerve.

Enlargement of the joints. Your affected joints can get bigger as a result of facet arthrosis. The condition may also enlarge some supporting tissue around your joints (ligaments).

It can be difficult to diagnose the cause of lower back pain. Certain imaging tests like magnetic image resonance (MRI), X-rays, and computed tomography (CT) scans can help your health care provider see if arthrosis has caused any visible damage to your facet joints and surrounding tissue.

A technique called a diagnostic medial branch block is often the surest way of obtaining a diagnosis. Medial branch blocks are injections inserted near the medial nerve, near the facet joint.

A set of two injections are performed at different times. If both injections cause the pain to stop for a period of time, it’s usually a confirmation of facet arthrosis, and your doctor can recommend a treatment plan.

The first course of treatment for facet arthrosis is typically the least invasive. It usually involves several methods that are aimed at pain relief and strengthening your muscles:

  • Anti-inflammatory pain relievers such as ibuprofen or acetaminophen
  • Heat or ice packs applied to the affected area
  • Avoiding movements that cause the pain to flare
  • Physical therapy focused on strengthening and stretching the affected muscles
  • Core strengthening exercises
  • Massage

If these methods don’t have an effect on the pain, other methods may be used for pain management.

Radiofrequency ablation is a procedure that temporarily destroys the medial nerves. It uses heat to damage the nerve, which reduces pain. The procedure will need to be repeated every 6 to 12 months. It’s important to remember that ablation only treats the symptoms of facet arthrosis. You will need to take proper care of your health in order to manage the disease in the long term.

In severe cases, your doctor may recommend surgery. Talk to your medical team to figure out which therapy or treatment could work best for your needs.