Condition

Facet Joint Syndrome Treatment in Tallahassee, FL

Chronic neck or back pain that worsens with bending backward or prolonged standing is often coming from the facet joints — and there are well-established, minimally invasive treatments that can provide meaningful and lasting relief.

Overview

What Is Facet Joint Syndrome?

Facet joint syndrome — also called facet arthropathy or spinal arthritis — is a condition in which the small joints that connect the vertebrae of the spine become inflamed, arthritic, or degenerated. These joints, known as facet or zygapophyseal joints, are present at every level of the spine and play an essential role in guiding and limiting spinal movement. When they break down, they can generate significant chronic pain that is often underdiagnosed or attributed to other causes.

Facet joint syndrome is one of the most common causes of chronic axial neck and back pain in adults — meaning pain that is localized to the spine itself rather than radiating into the arms or legs. It frequently coexists with disc degeneration and other spinal conditions, which is why an accurate diagnostic evaluation is essential before selecting the right treatment.

Causes

What Causes It

Like arthritis in any other joint, facet joint syndrome most commonly develops as a result of age-related wear and tear. The cartilage lining the facet joints gradually breaks down over time, leading to inflammation, bone spur formation, and joint enlargement. Prior spine injuries, repetitive mechanical loading, adjacent disc degeneration, and poor posture can all accelerate this process. Facet joints in the lumbar spine are particularly vulnerable because they bear significant load with every movement of the lower back. Cervical facet joints are commonly affected by whiplash injuries and chronic postural strain from prolonged sitting or screen use.

Evaluation

How We Evaluate It

Facet joint pain cannot be reliably confirmed by imaging alone — degenerative changes are common on MRI and CT but do not always identify the primary pain source. The most accurate diagnostic approach is a medial branch block — a small, precisely placed injection that temporarily numbs the nerves supplying the facet joints at the suspected level. If a patient experiences significant pain relief following these blocks, it confirms that the facet joints are the primary pain generator and guides the treatment plan. We use this diagnostic-first approach to avoid recommending longer-term treatments before we have confirmed the source of pain.

Treatment

How We Treat Facet Joint Syndrome

The standard of care for confirmed facet joint pain begins with medial branch blocks — both as a diagnostic tool and as a therapeutic option that can provide meaningful short-term relief. When medial branch blocks confirm facet joint pain as the primary source, radiofrequency ablation of the medial branch nerves offers more durable relief by interrupting the pain signals from the affected joints using precisely targeted heat energy. This procedure typically provides six months to two or more years of relief and can be repeated as needed. Facet joint injections are another option that some providers use, though medial branch blocks are generally preferred as the diagnostic and therapeutic standard. For patients with refractory facet pain that has not responded adequately to ablation, peripheral nerve stimulation may be evaluated as a longer-term neuromodulation option.

Our approach is to confirm the diagnosis before committing to any longer-term treatment. Medial branch blocks are a low-risk, high-information procedure that allows us to be confident in our treatment recommendations rather than proceeding based on imaging findings alone. A consultation is the right starting point to determine whether facet joint syndrome is contributing to your pain.

Frequently Asked Questions

Common Questions

Facet joint syndrome is a condition in which the small joints connecting the vertebrae — called facet joints or zygapophyseal joints — become inflamed, arthritic, or degenerated, producing chronic pain in the neck or back. These joints are present at every level of the spine and play an important role in guiding spinal movement. When they break down or become inflamed, they can generate significant pain that is often worse with extension, rotation, or prolonged standing.
Facet joint pain typically produces a deep, aching pain localized to the neck or lower back that may radiate into the shoulders, upper back, buttocks, or thighs — but generally does not travel below the knee the way sciatica does. The pain is often worse in the morning, with prolonged standing, or with backward bending, and may improve with sitting or leaning forward. Patients sometimes describe a stiffness or catching sensation with certain movements.
Facet joint syndrome most commonly develops as a result of age-related degeneration — the same wear-and-tear process that affects other joints in the body. The cartilage inside the facet joints gradually breaks down, leading to inflammation, bone spur formation, and joint enlargement. Prior spine injuries, repetitive loading, poor posture, and adjacent disc degeneration can accelerate this process. It is one of the most common causes of chronic axial neck and back pain in adults.
Facet joint pain cannot be reliably diagnosed by imaging alone — MRI and CT scans can show degenerative changes in the facet joints, but these findings do not always correlate with the source of pain. The most accurate way to confirm facet joint pain as the primary pain generator is through medial branch blocks — small diagnostic injections that temporarily numb the nerves supplying the facet joints. If a patient experiences significant pain relief following these blocks, it confirms that the facet joints are the primary source and guides the treatment plan.
Radiofrequency ablation (RFA) uses heat generated by radiofrequency energy to interrupt the medial branch nerves that transmit pain signals from the facet joints to the brain. It is performed after medial branch blocks have confirmed facet joint pain as the primary source. RFA typically provides relief lasting anywhere from six months to two years or more, and the procedure can be repeated when pain returns. It is one of the most effective and durable treatments for confirmed facet joint syndrome.
Medial branch blocks provide temporary diagnostic and therapeutic relief — typically lasting weeks to a few months. Radiofrequency ablation provides more durable relief, often lasting six months to two years or longer depending on the individual. The medial branch nerves can regenerate over time, at which point the procedure can be repeated. For patients who do not respond adequately to these approaches, peripheral nerve stimulation offers a longer-term neuromodulation option.
Yes — facet joint syndrome is essentially arthritis of the spinal joints. Just as the cartilage in the knee or hip can break down with age and use, the cartilage in the facet joints of the spine undergoes similar degenerative changes. The terms facet arthropathy, facet joint syndrome, and spinal arthritis are often used interchangeably to describe the same underlying process of joint degeneration and inflammation.

Neck or Back Pain That Worsens When You Stand or Bend Back?

That pattern is one of the hallmark signs of facet joint syndrome. Our clinical team will evaluate whether medial branch blocks and radiofrequency ablation are right for you.

Request an Appointment (850) 559-2355