What is facet joint osteoarthritis?
Facet joint osteoarthritis (spondylarthrosis) refers to the wear and tear of the intervertebral joints (facet joints). These joints connect adjacent vertebral bodies and, together with the intervertebral disc between them and the ligaments surrounding the spine, form a functional unit. If multiple joints are affected, the condition is referred to as multisegmental facet joint osteoarthritis.
Due to the degeneration of the cartilage in the joints and the intervertebral disc, the space within the vertebral joints decreases. This places greater stress on the facet joints, which can lead to degenerative changes and painful inflammatory reactions over time. If joint wear is already advanced, specialists refer to hypertrophic facet joint osteoarthritis, in which not only cartilage breakdown occurs but also excessive bone growth (hypertrophy). These growths can narrow the spinal canal, which can lead to pain, restricted movement, and possible nerve irritation.
Starting around age 55, the facet joints—even before the sacroiliac joint (SIJ)—are among the most common causes of back pain, because degenerative changes and osteoarthritis increase over the course of a person’s life.1
Causes and Risks of Facet Joint Osteoarthritis
The primary cause of facet joint osteoarthritis is natural wear and tear. Over the years, the joint surfaces wear down and the cartilage thins.
Other risk factors include:
- Lack of exercise or repetitive strain
- Herniated discs
- Trauma and injuries to the spine
- Obesity (additional pressure)
- Spinal misalignments (such as scoliosis, lordosis)
- Occupational stressors, such as prolonged sitting or heavy lifting
Degenerative changes in the facet joints are often considered the cause of facet syndrome—that is, chronic back pain originating directly from these joints.
Can facet joint osteoarthritis be prevented?
Prevention is difficult, but the risk can be significantly reduced.
The key is to keep the spine flexible and the muscles strong by:
- Regular physical activity and exercises, particularly back training, swimming, or cycling
- Strengthening the core muscles to stabilize the spine
- Ergonomic work practices – a back-friendly sitting posture, a height-adjustable workstation
- A balanced diet and weight loss if overweight
- Avoiding prolonged strain and poor posture
Symptoms and Pain Associated with Facet Joint Degeneration
Facet syndrome can be triggered by a functional disorder or osteoarthritis affecting one or more vertebral segments. A typical symptom is a dull, localized pain in the lower back. The pain
- usually occurs when standing up from a sitting position or after prolonged standing
- may radiate into the buttocks or thighs without reaching the legs all the way to the feet (so-called pseudoradicular pain)
- often improves with movement or when resting, and intensifies when bending backward (hyperextension of the spine).
Diagnosis and Treatment of Osteoarthritis in the Facet Joints
Diagnosis is often challenging because there is no definitive clinical test for facet joint pain. Doctors first make a preliminary diagnosis based on the patient’s medical history and a physical examination. To confirm the diagnosis, test injections with a local anesthetic may be performed—if the pain improves afterward, the diagnosis is considered likely. Like all other forms of osteoarthritis, facet joint osteoarthritis is incurable: once joint degeneration has occurred, it is permanent.
Treatment options:
- Medication for pain management
- Exercise, physical therapy, and occupational therapy to strengthen muscles and relieve strain
- Injections of local anesthetics and, if necessary, cortisone under image guidance
- Heat therapy
- Radiofrequency therapy (thermocoagulation) for targeted pain relief
- For persistent symptoms: surgical procedures, tailored to the individual based on findings
After the acute phase, the focus shifts to muscular stabilization of the spine—particularly through pelvic tilt exercises and posture training.
Which doctor treats facet joint osteoarthritis?
The first point of contact is your primary care physician’s office. There, your symptoms will be assessed, and if necessary, you will be referred to a specialist, such as an orthopedic or neurosurgeon. These specialists have the necessary resources for diagnostic imaging and treatment.
Exercises for Facet Joint Osteoarthritis: Why Movement Is Important
Regular back exercises strengthen the deep core muscles, improve joint function, and reduce sensitivity to pain.
The following are particularly important:
- Mobility exercises to maintain flexibility
- Strengthening exercises for the back and abdomen
- Exercising within a pain-free range of motion
Guidance from a physical therapist helps ensure that the exercises are performed correctly and tailored to your individual needs.
Exercises for Facet Joint Osteoarthritis
Medical devices for facet joint osteoarthritis
Medical devices such as back braces can relieve pressure on the spine, stabilize it, and alleviate pain. The Lumbamed facet lumbar brace helps correct lordosis (by straightening the spine) by encircling and lifting the pelvis. Built-in stabilizing elements in the back provide targeted relief to the facet joints.
Highlights
The comfort line bandages and orthoses from medi
Comfort line
Product tip
The human body
An overview of the different causes of back pain and what can be done about it
Source:
1 Klessinger S, Wiechert K. Deutsche Wirbelsäulengesellschaft. S3-Leitlinie Radiofrequenz-Denervation der Facettengelenke und des ISG. Version 01, 2023. Online veröffentlicht unter: register.awmf.org/de/leitlinien/detail/151-004 (Last access 13/04/2026).
