Lumbar Facet Joint Arthropathy
Facet Joint Arthritis (also called Arthropathy) is a common and often overlooked source of chronic low back pain. Pain can be accompanied by stiffness and worsen with backward bending, twisting or standing for long periods of time.
The facet joints are small joints located along the back of the spine. They guide movement, provide stability, and allow the vertebrae to glide smoothly together. Over time, just like other joints in the body, the facet joints can degenerate. Cartilage break down, inflammation, and small bone spurs may occur.
Facet Arthropathy or arthritis occurs when the spinal disc loses height and places extra stress on the facet joints leading to chronic pain and stiffness. The weakness or instability in supporting spinal ligaments and muscles can accelerate this process. It is commonly seen with aging or degenerative disease.
Pain with Lumbar Facet Joint Arthropathy is caused by:
- Cartilage breakdown and joint inflammation lead to localized back pain, stiffness, and muscle tension.
- Joint swelling and bone spurs 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 have many sensory nerves. When the joint becomes inflamed, these nerves become hypersensitive, and even small movements can trigger sharp or aching pain that radiates into the surrounding muscles.
Symptoms
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
Diagnosis
Facet arthritis diagnosis uses a combination of:
- Patient History & Physical Examination
pain triggers (extension, twisting) and tests to provoke facet pain may be performed
- Imaging - Spinal X-ray, CT or MRIcan show joint degeneration, narrowing, bone spurs. Imaging alone is rarely conclusive, since many people have facet degeneration on scans without symptoms
- Diagnostic Facet Joint Injections - A small amount of anesthetic or prolotherapy solution can be injected into the facet joint or surrounding tissues. If pain is dramatically reduced, this can support the fact that the facet joint is a pain source.
Treatment
Traditional pain management options such as steroid injections and radiofrequency ablations (RFA) can provide temporary relief.
Regenerative Medicine: Healing and Stabilizing the Spine
At Athletic Orthopedics and Knee Center, 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.
- 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.
- 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
These Regenerative treatments are most effective when combined with a targeted physical therapy program that focuses on improving spinal strength, flexibility, and controlled mobility.
These lifestyle changes are often also recommended and can 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