Understanding Facet Joint Pain: Causes, Symptoms, and How Physical Therapy Helps

Facet joint pain is one of the most common sources of neck and low-back discomfort, affecting both athletes and everyday individuals. These small joints, located at each segment of the spine, play a major role in stability and smooth movement. When they become irritated or inflamed, the result can be persistent pain, stiffness, and difficulty with activities that involve bending, twisting, or prolonged sitting or standing.

Below, we break down what facet joint pain is, why it happens, and how physical therapy can help you find long-term relief.

What Are Facet Joints?

Facet joints are small, paired joints along the back of the spine. They guide movement and prevent excessive rotation or hyperextension. Over time - or after an injury - these joints can become irritated, swollen, or restricted, leading to localized pain and limited mobility.

Common Causes of Facet Joint Pain

Facet joint pain can develop gradually or suddenly, depending on the source. Common causes include:

Age-Related Degeneration

Wear and tear over time can lead to cartilage breakdown, inflammation, and increased joint stress.

Poor Posture

Prolonged sitting, slouching, or forward-head posture can overload the cervical or lumbar facets.

Repetitive Movements

Frequent bending, lifting, twisting, or hyperextension - common in sports and manual labor - can irritate the joints.

Acute Injury

A sudden movement, fall, or accident can strain the facet joints or surrounding tissues.

Arthritis

Osteoarthritis in the spine may narrow the joint space and increase pain and stiffness.

Symptoms of Facet Joint Pain

Facet joint irritation often presents with recognizable patterns, including:

• Localized pain in the neck or low back
• Stiffness, especially in the morning or after sitting
• Increased pain with extension (leaning backward) or rotation
• Pain that radiates into the shoulders, upper back, buttocks, or thighs (without nerve compression)
• Muscle spasms around the affected area
• Difficulty standing upright or transitioning from sitting to standing

These symptoms can mimic other spinal conditions, making an accurate diagnosis essential.

How Facet Joint Pain Is Diagnosed

A physical therapist or clinician will perform a comprehensive evaluation, which may include:

• A detailed medical history
• Postural assessment
• Range-of-motion testing
• Joint mobility testing
• Provocative movements to reproduce symptoms

In some cases, imaging such as X-ray or MRI may be used to rule out other causes or confirm facet involvement.

How Physical Therapy Helps Relieve Facet Joint Pain

Physical therapy is one of the most effective, research-supported treatments for facet joint dysfunction. At Core Performance Physical Therapy, we focus on identifying the root cause of your symptoms and restoring proper movement patterns.

Here’s how PT helps:

1. Manual Therapy to Improve Joint Mobility

Hands-on techniques such as joint mobilizations, soft tissue release, and gentle manipulation help reduce stiffness, relieve pain, and restore normal movement.

2. Targeted Strengthening

Weakness in key stabilizing muscles - such as the deep core, glutes, and spinal extensors - can increase stress on the facet joints. Strengthening helps offload the joints and improve long-term stability.

3. Posture and Movement Training

Improving posture during sitting, standing, lifting, and daily activities reduces strain on irritated joints and prevents recurrent flare-ups.

4. Flexibility and Mobility Exercises

Stretches and mobility drills for the hips, thoracic spine, hamstrings, and hip flexors help restore balance and improve spinal mechanics.

5. Activity Modification and Education

Understanding what movements help - and which ones aggravate - your pain empowers you to manage symptoms effectively between sessions.

6. Advanced Treatment Options (Clinic-Specific)

Your clinic may include specialized tools such as:

• LightForce laser therapy to reduce inflammation
• NormaTec compression for recovery in athletes
• ForceDecks testing to assess imbalances contributing to spinal stress

These tools complement traditional PT to accelerate healing and optimize performance.

When to See a Physical Therapist

You should seek physical therapy if you experience:

• Persistent neck or low-back pain lasting more than a few days
• Pain that worsens with extension, twisting, or standing
• Difficulty with activities you previously performed comfortably
• Recurrent flare-ups that disrupt work, exercise, or daily life

Early intervention leads to faster results and reduces the risk of chronic pain.

Find Relief From Facet Joint Pain at Core Performance PT

Facet joint pain doesn’t have to limit your movement, workouts, or daily comfort. With personalized treatment, hands-on care, and targeted exercise, physical therapy can help you regain mobility, reduce pain, and prevent future episodes.

If you’re experiencing facet joint pain, our team at Core Performance Physical Therapy is here to help you get back to moving pain-free.

Schedule an evaluation today and start your path toward lasting relief.