Facet joint pain comes from the facet joints, the pairs of small joints at the back of the spine where each vertebra meets the next. Their joint surfaces are covered with cartilage, and their job is to steady the spine and guide its movement. In the lower back, the ache usually sits along the spine, sometimes more to one side, and can spread into the buttock or thigh. It is one source of back pain among several, and our guide to lower back pain explains the broad kinds.
Arching backwards and twisting tend to aggravate facet pain
Leaning and standing for a while can bring it on too. Bending forward tends to ease it, and StatPearls, the clinical reference on NCBI Bookshelf, counts that pattern among the signs that suggest facet arthritis. The pain is also typically worse first thing in the morning or after a spell of inactivity.
Facet pain rarely travels below the knee, and MedlinePlus advises contacting a doctor right away if back pain does, or if it brings numbness or weakness in the leg. Our article on bulging and herniated discs explains what pain that travels can mean.
A scan can show worn facet joints without showing they cause the pain
A 2015 review in the American Journal of Neuroradiology estimated facet degeneration on the scans of about half of people aged 60 with no back pain, and more than four in five by 80. How worn a joint looks does not reliably match how much it hurts.
An examination can suggest the facet joints but not confirm them. NICE, which writes clinical guidance for the NHS, advises against routine imaging for low back pain outside specialist care.
Worn facet joints can also narrow the space for nerves or let a vertebra slip
An enlarged facet joint can narrow the spinal canal and press on nearby nerves, a route to spinal stenosis. Facet joint osteoarthritis is also often behind the degenerative kind of spondylolisthesis, where one vertebra slips forward on the one below.
Doctors confirm facet pain with a numbing injection, and whether you need one is their call
Usually guided by live X-ray or CT, a doctor places local anaesthetic into the joint or beside the medial branch, the small nerve that carries sensation from it. StatPearls calls this diagnostic block the gold standard and counts it as positive when the usual pain falls by four fifths or more while the anaesthetic lasts.
A single block can mislead, because that nerve also supplies nearby muscles and ligaments, and a second block on another occasion may be used to confirm the result. The injection has its own risks, including bleeding and infection.
A Sync specialist measures movement, and the diagnosis stays with your doctor
SpinalSync tests each segment of your spine on its own, with the readings on a screen as they are taken, and repeat measurement shows what has changed. Adjustments are delivered at a controlled force, angle and depth, and manual adjustment is still used when it is the right call. MyoSync works with the fascia and soft tissue around the spine.
The aim is comfort and easier movement. The Sync does not diagnose, prescribe medication, inject, operate, or provide or read imaging, and if your pattern points to something a doctor should see first, a Sync specialist says so early. The methods page explains how SpinalSync and MyoSync work.
Common questions about facet joint pain
The two often overlap. StatPearls names wear-related degeneration, or osteoarthritis, as the most common cause of facet joint disease, with injuries and inflammatory conditions such as ankylosing spondylitis among the others. Worn facet joints are also common in people with no pain, so arthritis on a scan report does not by itself explain yours.
Either can bring it on, since both positions are known triggers for facet pain. The pain often feels worse after rest and may improve with gentle movement.
Guidance differs. StatPearls describes facet injections as a diagnostic tool that may also help with pain, while NICE, which writes clinical guidance for the NHS, advises against spinal injections as a treatment for low back pain. NICE does leave room for denervation, a procedure that disables the small nerves supplying the joint, in some people with long-standing low back pain, but only after a positive diagnostic block on those nerves.
No. Pinning down the source is a medical diagnosis, made by a doctor and sometimes confirmed with a diagnostic block. A Sync specialist assesses and measures how your spine moves, supports comfort and movement with care that is gentle by design, and says early if something needs a doctor first.
Written by the Aphyx Content team, reviewed by the clinical team at The Sync. Published 21 October 2026. Last updated 21 October 2026.