Kinematics Team FAQ: Lumbar Facet joint arthropathy (common cause of lower back pain)
August 7thLumbar facet joint arthropathy
Run your fingers down either side of your lumbar spine (lower back) and you’ll feel bony bumps. Beneath each sits a facet joint. One of paired joints linking each vertebra to the one below. They guide bending and straightening while limiting rotation (twisting) movement in your lumbar spine.
Like knee cartilage, their cartilage often degenerates with age, which is also known as facet joint arthropathy (arthritis). It sounds serious, but a large population of people develop varying degrees of degeneration over time without pain. An imaging finding seldom explains symptoms you might be experiencing or reflect ‘weakness’ in your back.
Where will I feel pain with lumbar facet joint arthropathy?
Pain is felt low in the back, around belt height or just above your hips, and often more on one side and less central. It can feel like a deep ache or a twinge rather than sharp shooting pain. It may spread into the buttock or upper thigh, but rarely further.
What movements will I struggle to perform if I have facet joint pain?
Forward leaning movement and sitting tends to be well tolerated. Whereas bending backwards, movement of standing from sitting, or twisting movement can be more symptomatic, as these movements load facet joints most. Reaching into a high cupboard, standing upright after gardening, or looking over the shoulder while reversing can trigger it.
Getting up from a low couch or bed may feel stiff. Holding an extended position, such as washing dishes, ironing or leaning over a workbench, may irritate more than moving.
Gentle movement such as walking often is pain free and can even be soothing.
Will I feel pain in any other regions of my body?
Usually not. Facet joint pain stays in the lower back, buttock or upper thigh. Symptoms such as pins and needles, numbness, weakness or electric pain traveling below the knee can suggest radiculopathy where nerves are irritated and/or affected.
New or persisting and worsening symptoms should always be discussed with a Physiotherapist or Osteopath.
How does lumbar facet joint arthropathy happen?
Facet joint arthritis develops as years of load wear the cartilage. It is rarely one incident, but rather repeated backward bending and rotation, perhaps through work or sports. History of injury in the lower back can contribute to a higher likelihood of pain as you age.
Reduction in strength in stabilising muscles such as deep core and gluteal muscles, or an increase in stiffness in the thoracic spine can lead to an abnormal load distribution into the lower back. As mentioned above, pain can often occur not from the gradual degeneration that occurs with age, but more likely with a suboptimal movement pattern leading to increased mechanical stress into the lumbar facets.
What should I do about my lumbar facet joint arthropathy?
Maintain guided and controlled movement, best with the guidance of a physiotherapist. Complete rest can increase stiffness and will not assist with restoring an optimal movement pattern. A short gentle walk, even around the block, is often a good first step.
Avoid staying locked in a sitting or standing position; change posture, shift your weight and move regularly. Heat may help stiffness.
A physiotherapist or osteopath can assess what is driving your pain and build a clearer plan.
What things should I try to avoid in the initial stages of facet joint pain?
Initially, reduce movements that flare symptoms like heavy lifting with a rounded or over-arched back, forceful twisting, or prolonged leaning backwards.
Some soreness during activity does not automatically mean damage. Distinguishing normal adaptation from a genuine flare-up is where guidance helps.
What type of exercises or movements are helpful for rehabilitation?
Rehab builds strength through your core, glutes and hips to reduce increased pressure on the facet joints. Bridges, controlled hip hinges and gradual rotational strengthening may be included.
Promoting good hip mobility can minimise compensation through the lower back.. Improving functional movement patterns, such as lifting from the floor or carrying shopping without arching your lower back is essential as well. Over time, you will gain confidence in tasks you once avoided.
What treatments can help relieve some pain or fast track my facet joint rehabilitation?
Hands-on treatment focusing on joint mobilisation, soft tissue release through the lower back, hips and mid-back may reduce stiffness and restore movement. A graded program for core and hip strength supports longer-term progress.
Dry needling or deep tissue massage are common modalities that can help reduce tension in surrounding muscles that tightens through compensation. Activity pacing and exposure to avoided movements are woven through the process.
What are the expected timeframes of rehabilitating lumbar facet joint arthropathy?
Facet joint arthritis does not follow a neat tissue-healing timeline. Many people notice changes in pain and stiffness within four to six weeks of structured rehab, while building movement pattern, strength and resilience often takes several months.
The aim is fewer flare-ups, shorter setbacks and a back that handles more. If symptoms keep limiting walking, work or training, book a physiotherapist who can assess your back and map the starting point.
This article is for general education and is not a substitute for personalised medical advice.