Each motion segment in the lumbar spine contains two facet joints—one on the left and one on the right.
Together with the intervertebral disc, these joints allow controlled movement while preventing excessive motion.
Please review the Lumbosacral spine anatomy section for more information.
As the spine ages, increased stress on the facet joints may cause cartilage wear, inflammation, enlargement of the joints, or instability.
Major Diagnosis Types
Below are the major types we see in our clinic. Click on available links to learn about our approach to the problems.
Facet Arthritis
Facet arthritis occurs when the cartilage lining the facet joints gradually wears away. The joints become inflamed and may develop bone spurs.
Facet arthropathy is one of the most common causes of chronic mechanical low back pain.
Lumbar Synovial (Facet) Cyst
A synovial cyst is a fluid-filled sac that develops from an arthritic facet joint.
Although the cyst itself is benign, it may compress nearby nerves and cause leg pain, numbness, weakness, or symptoms of spinal stenosis.
Minor Diagnosis Types
These terms are often encountered, but are either less often treated or described within one of the above diagnoses.
Facet Joint Effusion
A facet joint effusion is an abnormal collection of fluid within the facet joint.
Facet effusions may indicate inflammation or abnormal movement of the spinal segment and are sometimes associated with spinal instability or degenerative spondylolisthesis.
Facet Joint Hypertrophy
Facet joint hypertrophy refers to enlargement of the facet joints caused by chronic arthritis and remodeling.
As the joints enlarge, they may narrow the spinal canal or neural foramina, contributing to spinal stenosis.
Facet-Mediated Low Back Pain
Not all painful facet joints produce visible abnormalities on imaging.
Facet-mediated pain occurs when the facet joint itself is the primary source of pain. This diagnosis is often confirmed with carefully performed diagnostic facet joint injections or medial branch blocks.