If we think of the spinal motion segment as a tripod, we can visualize the disc as the front leg and the facet joints as the two back legs.
While the disc functions as a shock absorber, the right and left facet joints are gliding joints, which allow motions such as bending and twisting. Facet joints have cartilage on the inside and a capsule (envelope) surrounding the outside. Pain that comes from the facet joints is termed facet syndrome. Facet syndrome is more common in the neck and lower back, as there is more movement at those levels.
Facet joints can be injured in accidents such as car accidents (whiplash) or can become painful due to degeneration or arthritis. Some patients develop pain in their facet joints at the level of a previous fusion.
Patients with facet syndrome usually have pain directly over the joints themselves. Typically, they do not have compression of a spinal nerve, so the pain doesn’t extend into the arms or legs.
Treatment options for patients with facet syndrome include anti-inflammatory medications, physical therapy, chiropractic treatments, or facet joint injections. Surgery is usually not recommended for patients with pain due to facet syndromes.