The cervical facet joints are small joints located at the back of the neck that connect each vertebra to the one above and below it. These joints help guide motion, provide stability, and allow the neck to bend, rotate, and extend smoothly.
Like any other joint in the body, the cervical facet joints can become worn, injured, or inflamed. Facet disorders are a common cause of chronic neck pain and may also contribute to spinal instability, nerve compression, or degenerative changes within the cervical spine.
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
Cervical facet arthritis, also called facet osteoarthritis, occurs when the cartilage covering the joint gradually wears away.
As the cartilage deteriorates, the joint becomes inflamed and irregular. The body often responds by forming bone spurs around the joint, which may further narrow the spaces available for nearby nerves.
Facet arthritis commonly develops as part of the normal aging process but may occur earlier following previous injury, repetitive stress, or abnormal spinal alignment.
Symptoms often include:
- Chronic neck pain
- Morning stiffness
- Pain that worsens with extension or rotation
- Reduced range of motion
- Muscle tightness
Facet arthritis frequently occurs together with degenerative disc disease.
Minor Diagnosis Types
These terms are often encountered, but are either less often treated or described within one of the above diagnoses.
Facet Effusion
A facet joint effusion is an abnormal collection of fluid within a facet joint.
An effusion may indicate:
- Joint inflammation
- Active arthritis
- Increased motion
- Segmental instability
Facet joint effusions are identified on MRI and are interpreted together with the patient’s symptoms and other imaging findings.
Although an effusion alone does not prove instability, larger effusions may suggest abnormal movement at that spinal level.
Facet Fractures
Facet fractures typically occur following trauma such as motor vehicle accidents, falls, or sports injuries.
The severity of injury varies considerably.
Some fractures remain stable and heal with nonsurgical treatment, while others result in instability that requires surgical stabilization.
Associated injuries may include:
- Ligament injuries
- Disc injuries
- Nerve root compression
- Spinal cord injury
- Vertebral artery injury
Prompt medical evaluation is important following significant cervical trauma.
Facet Hypertrophy
Facet hypertrophy refers to enlargement of the facet joints caused by chronic arthritis and degeneration.
As the joints enlarge, they may contribute to narrowing of the spinal canal or the openings where the cervical nerves exit the spine.
Facet hypertrophy commonly occurs together with:
- Degenerative disc disease
- Bone spur formation
- Thickening of nearby ligaments
- Cervical spinal stenosis
- Cervical foraminal stenosis
Many patients have facet hypertrophy on imaging without symptoms. Treatment depends on whether the enlarged joints are contributing to pain or nerve compression.
Facet Instability
Facet joints help stabilize the cervical spine during movement.
Degeneration, trauma, ligament injury, or previous surgery can reduce the stability provided by these joints.
Facet instability may contribute to:
- Mechanical neck pain
- Abnormal vertebral movement
- Progressive degeneration
- Cervical spondylolisthesis
- Recurrent nerve compression
Instability is evaluated using the patient’s symptoms, physical examination, and imaging findings.
Facet Syndrome
Facet syndrome refers to pain that originates from one or more facet joints.
Unlike nerve compression, facet syndrome usually produces localized neck pain rather than pain that follows a specific nerve distribution.
Patients often describe:
- Aching neck pain
- Pain when looking upward
- Pain when turning the head
- Stiffness after inactivity
- Pain that improves with rest
The pain may spread into the shoulder, upper back, or back of the head without extending below the elbow.
Because several cervical conditions can produce similar symptoms, careful evaluation is necessary to determine whether the facet joints are truly the source of pain.