Lumbar Facet Arthropathy

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What is Lumbar Facet Arthropathy?

Lumbar facet arthropathy refers to degenerative changes in the small joints located at the back of the spine, known as the facet joints. These joints connect Visualization of lumbar spine inflammation and joint degeneration linked to facet arthropathy and chronic back pain. vertebrae, guide movement, and provide stability. Over time, everyday stress, poor posture, repetitive lifting, or injury can wear down the protective cartilage that lines the facet joints. When that cartilage thins or breaks down, the exposed bone surfaces rub against each other, leading to inflammation, stiffness, and pain.

Facet arthropathy commonly develops as part of the natural aging process, but it can also result from trauma, poor biomechanics, or secondary conditions such as degenerative disc disease and osteoarthritis. The pain it causes often mimics that of other spinal conditions, so an accurate diagnosis by a spine specialist is essential.

Causes and Risk Factors

Facet joint degeneration often occurs gradually. As the intervertebral discs lose height and hydration, they transfer more pressure to the facet joints, accelerating wear. Common causes and contributing factors include:

Repetitive bending, twisting, or heavy lifting
Previous spinal injury or surgery
Chronic poor posture or prolonged sitting
Obesity and lack of core strength
Age-related cartilage breakdown
Coexisting spinal conditions such as spondylosis, spinal stenosis, or scoliosis

In some cases, arthritis of the facet joints coexists with disc degeneration, creating a cycle of inflammation and stiffness known as facet syndrome.

Recognizing the Symptoms

Symptoms of lumbar facet arthropathy can range from mild discomfort to severe pain that limits mobility. The hallmark sign is localized pain in the lower back that often worsens with extension (arching backward) or rotation. Pain may also radiate into the buttocks or upper thighs, but rarely below the knee.

Other common symptoms include:

Morning stiffness that improves with gentle movement
Muscle spasms in the lower back
Pain triggered by prolonged standing, walking downhill, or twisting
Reduced range of motion when bending backward or sideways

Due to the overlap of these symptoms with those of herniated discs or nerve compression, imaging techniques such as X-ray, CT, or MRI may be necessary for an accurate diagnosis.

Treatment Options for Lumbar Facet Arthropathy

Most patients improve with a conservative, stepwise approach. Your orthopedic spine specialist will develop a personalized plan to relieve pain, restore movement, and protect long-term spinal health.

Non-surgical treatments may include:

Anti-inflammatory or pain-relief medications
Targeted stretching and physical therapy to strengthen supporting muscles
Heat or cold therapy to reduce inflammation and stiffness
Chiropractic adjustments or gentle mobilization to improve joint mechanics
Core-strengthening and posture training exercises
Activity modification to limit strain during flare-ups

When conservative care does not provide lasting relief, interventional options may help reduce inflammation and interrupt pain signals:

Facet joint injections deliver corticosteroid medication directly into the affected joints.
Medial branch blocks numb the nerves that supply the facet joints, confirming the pain source.
Radiofrequency ablation can provide longer-term relief by using heat energy to disrupt pain-carrying nerves.

In rare cases where severe degeneration contributes to spinal instability or nerve compression, spine surgery may be considered to restore alignment and reduce mechanical stress.

Prevention and Long-Term Management

You can support healthy facet joints by maintaining strong core muscles, practicing proper posture, and avoiding repetitive stress on the spine. Regular exercise, weight management, and ergonomic workspace adjustments also help protect spinal structures. If you’ve already been diagnosed with facet arthropathy, ongoing physical therapy and periodic check-ins with your provider can help prevent flare-ups and preserve mobility.

When to Seek Specialist Care

Persistent lower back pain that interferes with sleep, exercise, or work deserves professional attention. An experienced orthopedic spine specialist can determine whether facet arthropathy or another spinal issue is causing your pain and tailor a plan to accommodate your daily life and long-term goals.

At Texas Orthopedic & Spine Associates, our spine specialists combine advanced imaging, hands-on evaluation, and targeted therapies to relieve pain and improve function. We emphasize conservative management first and progress to interventional or surgical options only when appropriate.