Facet joint degeneration is the slow wearing down of the small joints in the spine that help the back move and stay stable. These joints are lined with smooth cartilage, which lets the bones glide against each other with less friction. Over time, that cartilage can break down, and the joints may become irritated or inflamed. This can lead to pain in the lower back, and in some cases, nearby nerves may also be affected.What

Happens as the Joints Wear Down?

The process often happens in stages:
  1. Healthy cartilage becomes worn
  2. The joint loses its smooth padding
  3. Bones begin rubbing more directly against each other
  4. Extra bone may form around the joint
  5. Inflammation and nerve pressure can develop
  6. As the cartilage thins, the joint has less protection
At the same time, the spinal discs may also lose height with age, which shifts more stress onto the facet joints. This added pressure can speed up the damage. The body may respond by growing small bone spurs around the joint. These spurs can narrow the spaces where nerves travel, which may cause more pain or discomfort.


Common Symptoms

  • Pain in the lower back that feels deep and aching
  • Pain that may spread into the buttocks or upper thighs
  • Pain that often gets worse when standing, twisting, or leaning backwardStiffness in the morning or after sitting still for a while
  • Short-term relief when bending forward
  • Many people notice that extension movements, like arching the back, make symptoms worse because they put more pressure on the joints.
  • Bending forward can sometimes ease the pain by opening up the space between the bones.


Treatment Options

Treatment usually starts with simple, non-surgical care and moves to other options if needed.

Conservative care may include:
  • Physical therapy to strengthen the back and core
  • Anti-inflammatory medicineChanges in activity to reduce strain
Interventional treatments may include:

  • Facet joint injections to reduce pain and swelling
  • Medial branch blocks to check whether the joint is causing the pain
  • Radiofrequency ablation to interrupt pain signals from the nerves

If nerve pressure becomes severe, surgery may be considered. Options can include:
  • Decompression surgery to relieve pressure on nerves
  • Spinal fusion to stop movement at the painful joint
  • Motion-preserving implants like the TOPS procedure in some cases