Pain Management Physician

Facet arthropathy can affect the cervical, thoracic, and/or lumbar spine.  These small joints, also known as z-joints or zygapophysial joints, can be affected acutely or damaged from chronic wear and tear.  In the low back, these joints can be loaded or stressed by extension and lateral rotation (bending back at the waist and to one side).  If your usual pain is reproduced when making this motion without any leg pain, this is likely pain from your facet joints.  Pain can sometimes radiate to the buttocks and/or thigh, but rarely below the knee. 

In the neck, facet pain is reproduced when laterally flexing the neck (trying to touch your ear to your shoulder), as well as extending the neck (looking upwards).

Each individual joint has two nerves that supply it called medial branches.  These nerves are important in the treatment of facet-mediated pain.  This treatment involves medial branch nerve blocks and radiofrequency nerve ablation.

X-rays and MRIs can sometimes be helpful in diagnosing facet pain, but physical exam and diagnostic medial branch nerve blocks are most accurate.