Facet Arthritis: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Facet Arthritis?
A spine specialist, such as an orthopedic doctor (a bone and joint doctor) or a physiatrist (a doctor who treats pain and movement problems), often treats facet arthritis. Many people start with treatments that do not need surgery. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is facet arthritis?
The facet joints are small joints in the back of the spine. Each one links one bone of the spine (a vertebra) to the next. Facet joint osteoarthritis, or wear-and-tear arthritis, is the most frequent form of facet joint syndrome.
This kind of arthritis affects the whole joint, not only the cartilage. The joint space can get narrower and the cartilage thinner, and bone spurs called osteophytes can form.
Symptoms
Facet joint pain typically shows up as pain in the low back. It can also be felt in the hip or thigh.
- Stiffness that is short-lived in the morning or after you have been still for a while.
- Pain that can spread to the buttock and thighs, usually stopping above the knee.
- Muscle weakness is usually not seen, unlike with pain from a pinched spinal nerve.
Light exercise, such as walking or gentle stretching, can help reduce the pain.
Causes and who gets it
Facet joint arthritis becomes more common with age. Facet joints are the source of pain in about 27% to 40% of people with low back pain.
Repeated injury to the spine and facet joints can also lead to long-lasting low back pain. Bending backward or repeated flexing can put heavy strain on the joint capsules in the low back.
How doctors diagnose it
A doctor asks about your history, checks where the pain spreads, and examines you. Imaging tests such as X-rays, CT, and MRI may help. But these steps may suggest facet joint syndrome without confirming it.
A CT scan is the preferred way to image the joint, and standard X-rays show changes best in severe disease. Imaging often does not match symptoms. Its main use may be to rule out more serious problems.
A block with numbing medicine is perhaps the most effective way to find out if a facet joint is the source of pain.
Treatment
Short-term pain relievers, including NSAIDs (anti-inflammatory pain medicines), may be used. They offer limited long-term benefits and must be used with caution because of possible side effects.
Physical therapy is a key part of care. It focuses on core strengthening and aerobic exercise.
Injections of steroid medicine into the joint can help for a while, but many people do not get long-term relief.
Radiofrequency ablation uses heat to damage the small nerve that carries pain signals from the joint. When other care fails, it can give lasting relief in well-selected patients and has a favourable safety profile. The relief does not last forever. Possible problems include infection, bleeding, more pain, and numbness.
Research does not currently support surgery for facet joint pain.
When to see a doctor
A doctor first rules out serious causes of back pain, such as a spine fracture, cancer, or an infection in the spine.
Call 911 or go to the emergency room if back pain follows a head or spine injury, or comes with sudden weakness.
Contact your doctor right away, or go to the emergency room, if back pain comes with any of these signs:
- Loss of control over urine or stool.
- Weakness or numbness in your buttocks, thighs, legs, or pelvis.
- Fever with no clear cause.
- A history of cancer.
- Weight loss that you did not plan.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Such a doctor can do an exam, follow your progress, and coordinate specialists if you need more care.
Common questions
Does facet arthritis cause leg pain?
It can, but the pain usually stays above the knee. Pain that spreads further is more likely to come from another cause.
Can a scan show that facet arthritis is causing my pain?
Not always, because scans often do not match symptoms. Imaging may still help rule out more serious problems.
Does exercise help facet arthritis?
Yes, light exercise such as walking or gentle stretching can help reduce the pain. Physical therapy that builds the core is also a key part of care.
Do I need surgery for facet arthritis?
No, research does not currently support surgery for facet joint pain. Care starts with options such as pain relievers and physical therapy.
Sources
- NCBI - Lumbar Facet Joint Disease: What, Why, and When?
- NCBI - Facet Joint Syndrome: Pathophysiology, Diagnosis, and Treatment
- MedlinePlus - Low Back Pain - Acute
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
