The spine is composed of individual bones called vertebrae, connected by small facet joints. These joints, found at each spinal level, allow for movement like bending and twisting while also limiting excessive motion to protect the spine. When irritated or inflamed, facet joint pain can develop, affecting daily activities and overall comfort. This article describes the sensations and characteristics of facet pain.
Characteristics of Facet Pain
Facet joint pain is often a dull, aching sensation, typically localized to the lower back or neck, though it can also occur in the mid-back. It is usually felt on one side of the spine, near the midline, but can sometimes be bilateral if both joints at a spinal segment are affected. Localized tenderness may also be present when pressure is applied directly over the affected facet joint.
Pain originating from the facet joints can also follow specific referral patterns, meaning it may be felt in areas away from the actual joint. For example, lower back facet pain might refer to the buttocks, hips, or thighs, while neck facet pain can radiate to the shoulder, upper back, or even the back of the head. Importantly, facet joint pain rarely extends below the knee or elbow, which helps distinguish it from other conditions involving nerve compression. Stiffness, particularly in the morning or after periods of inactivity, is a common symptom, often improving as physical activity resumes.
Activities That Influence Facet Pain
Facet pain is dynamic, changing with specific movements and activities. Activities involving backward bending (extension), twisting the torso, or prolonged standing commonly aggravate facet pain. This is because these movements compress or stress the facet joints. Sitting for extended periods, such as while driving, can also worsen the discomfort.
Conversely, certain positions and activities can help alleviate facet pain. Bending forward (flexion) often provides relief, as this movement can decompress the facet joints. Rest and lying down in specific positions may also reduce symptoms. Gentle, low-impact activities like walking, swimming, or cycling are generally recommended as they promote circulation and strengthen supporting muscles without excessive strain on the joints.
Distinguishing Facet Pain from Other Conditions
Differentiating facet pain from other spinal conditions is important for accurate diagnosis. Unlike disc pain, which often causes radiating nerve pain (sciatica) that can travel down the leg or arm, facet pain typically does not produce widespread neurological symptoms like numbness, tingling, or weakness in the limbs. Disc pain is often aggravated by bending forward or prolonged sitting, whereas facet pain tends to worsen with backward bending. While both can cause localized back pain, disc-related pain often presents with a more prominent radiating component that follows a nerve pathway.
Muscle strain, another common cause of back pain, generally feels more diffuse and less localized than facet pain. Muscle pain might also respond differently to rest and activity, often being more widespread and less directly tied to specific spinal movements like extension or twisting. Facet pain is primarily mechanical, localized to the joint, and usually lacks the neurological signs seen with disc herniations or nerve compression. Imaging, such as X-rays or MRI, can show degenerative changes in facet joints, while disc issues might reveal herniations or bulges compressing nerves.
When to Seek Medical Advice
Consult a healthcare professional if back pain persists for more than a few weeks or does not improve with self-care measures. Seek medical evaluation if the pain significantly interferes with daily activities, making tasks like walking, bending, or sleeping difficult. New symptoms such as weakness, numbness, or tingling in the arms or legs warrant immediate attention, as these could indicate nerve involvement. Additionally, if pain develops suddenly after an injury or trauma, or if there are any associated symptoms like fever, unexplained weight loss, or changes in bowel or bladder function, seek medical advice promptly.