Lumbar Facet Joint Pain

Overview

Each lumbar vertebra connects to the one below it through a pair of small joints at the back of the spine called facet (or zygapophyseal) joints. They guide and limit movement, and like any joint they are lined with cartilage and wrapped in a capsule rich in nerve endings. When a facet joint is overloaded, sprained or worn, it can become a source of persistent lower back pain.

Facet pain tends to be felt as a localised ache to one or both sides of the spine, sometimes spreading into the buttock or back of the thigh but not usually below the knee. It is classically worse when you arch backwards, stand for long periods, or twist, and is often stiff first thing in the morning before "loosening up" with movement. Many people find sitting or bending forward brings relief, which is the opposite of disc-related pain.

Facet joints can be irritated at any age by a sudden twist or an awkward lift, but wear-related facet pain becomes more common from middle age onwards and can coexist with disc degeneration. It usually responds well to hands-on treatment combined with exercises that reduce the load through the joints.

Causes and risk factors

• A sudden twisting or arching movement, such as reaching behind you or a bad golf swing
• Standing or walking for long periods, particularly with a hollow lower back
• Sports involving repeated back extension: gymnastics, cricket bowling, swimming, tennis serves
• Age-related wear of the joint cartilage
• Loss of disc height, which increases the load on the facets
• Weak abdominal and gluteal muscles that let the pelvis tip forward
• Being overweight

How we may be able to help

Our assessment looks at the pattern of your pain — what makes it worse and what eases it — alongside a hands-on examination of each lumbar segment to find the painful level. We check your hips, nerves and posture so we can be confident that the facet joint is the main driver.

Our chiropractor often leads treatment for facet-related pain: mobilisation and manipulation of the stiff, irritated segment can quickly improve movement, and many people notice an immediate change. Our physiotherapists address the reasons the joint became overloaded, using manual therapy and a programme that strengthens the deep abdominals and glutes, improves hip mobility, and teaches you to control the arch in your lower back during standing and sport.

Dry needling can relieve the tight lower-back muscles that often splint a sore facet joint. Interferential therapy is a useful adjunct for pain and stiffness in the early phase. If posture is a contributing factor, a 3D posture scan measures your pelvic tilt and lumbar curve so we can target what matters and track improvement.

What you can do at home

• Avoid prolonged standing; if you must stand, rest one foot on a low step and swap sides regularly
• Try knees-to-chest and pelvic tilt stretches to ease the morning stiffness
• Sit down for a few minutes when back pain builds on your feet
• Use heat in the morning to loosen stiff joints and muscles
• Strengthen your glutes and abdominals with bridges and dead bugs as shown by your therapist
• Avoid repeated arching movements and heavy overhead lifting until the joint settles