What Is Facet Arthrosis?

Written by Alyson Powell Key
Medically Reviewed by William Brady, DO on August 11, 2025
8 min read

Facet arthropathy is another name for osteoarthritis in your facet joints. It's a type of arthritis in the facet joints of your spine. These joints allow you to turn and bend your spine and are located on each side of your spinal vertebrae. They also prevent you from moving your spine too much, keeping your spine stable.

"Just like we have joints in our knees and in our hips, we have joints in our spine," says Joshua Eisenberg, MD, an orthopedic surgeon at University of Iowa Health Care Medical Center. "Those are the facet joints, and there's two at each level, one on the left and one on the right." 

Minor lower back pain is fairly common, but serious, constant back pain can happen with facet arthrosis. It can affect your spine as you get older, after an injury, or trauma to your spine. The cartilage that cover the ends of your spinal bones can wear down over time inside your joints. This cartilage cushions the inside of your facet joints, but as it becomes thinner, you can get arthrosis.

Symptoms of facet arthropathy can affect your quality of life. Find out what causes this condition and ways to manage and treat your facet arthropathy.

Your facet joints can degenerate (wear down) over time and you can get arthrosis for many reasons. Sometimes you may have problems with your spinal discs that can put more pressure on your facet joints. This can damage the joints and lead to facet arthropathy.

You can also have a higher risk for facet arthrosis if you have:

  • Osteoarthritis
  • Trauma or fractures to the area near your facet arthrosis
  • Disk problems that cause wear and tear on your facet joints
  • Repetitive stress on your facet joints
  • Intense use of your joints from sports, exercise, or other activities

Combined with poor body mechanics, such as bad posture, your facet joints can become inflamed over time. And after arthritis develops, your back may not function properly. Your spine may not be properly aligned, and certain motions, such as twisting and turning, can be painful. That's because your facet joints are key to the proper function of your back.

Normally, each facet is covered by cartilage and enclosed in a capsule filled with fluid. The fluid offers padding and lubrication against other spinal joints.

"Over time, with wear and tear or age, the cartilage will decrease its overall strength or cushion, and then we develop arthritis, which is essentially bone on bone in those joints," Eisenberg says. "Back pain can stem from many places; however, a lot of times it's coming from those facet joints as they become arthritic over time."

This can cause discomfort, even serious pain in the back and other areas of your body. It depends on which part of your body the condition affects, but you may get arthrosis in your:

  • Neck joints -- cervical
  • Lower back and spine joints -- lumbar
  • Upper back and rib area -- thoracic
  • Multiple joints in your spine -- multilevel
  • Both sides of the spine -- bilateral
  • Arthritis or disease that weakens your joints -- degenerative
  • Larger than normal joints -- hypertrophic

You're more likely to get facet arthrosis if you:

  • Are an older adult
  • Have a spine injury
  • Have degenerative disk disease
  • Have a family history of osteoarthritis
  • Have overweight or obesity
  • Have poor posture
  • Bend or twist your back a lot (sports, exercise, or overuse)

Many people get lower back, middle back, and neck discomfort with facet arthrosis. But other conditions like disk problems commonly happen with this type of arthrosis and can make your exact symptoms hard to define. Your symptoms can depend on which facet joints have arthrosis, too.

This pain can feel like a dull ache or be constant. Other symptoms of the condition include:

  • Low back pain that gets worse when you twist, stand, or stretch backward, if you have lumbar arthrosis
  • Low back pain that spreads to your bottom and the back of your thighs, with lumbar facet arthropathy
  • Stiffness that makes it hard to stand up from a sitting position
  • Trouble moving your head or turning your neck, if facet arthrosis affects your cervical spine
  • Muscle spasms

You can also feel stiff in the morning and your pain may worsen with movement, standing, or sitting.

When to call the doctor

Injury or damage to your spine can lead to spinal cord and nerve problems. Sometimes, you may need urgent medical treatment.

Call 911 or get medical care right away if you get:

  • Serious lower back pain
  • Serious leg pain (sciatica)
  • Weakness in your leg
  • Numbness, prickling, or tingling in the backs of your legs, butt, hip, and inner thighs
  • Problems holding your pee (urinary incontinence)
  • Problems holding your poop (fecal incontinence)
  • Problems peeing (you can't pee or are retaining pee)
  • Trouble moving your hands, arms, legs, or neck

Facet arthrosis usually doesn't go away without treatment, but there are many ways you can manage your condition and live actively. The condition can slowly break down your joints in your spine, but you can take steps to prevent your condition from worsening. 

"The best treatment is maintaining good spine posture, a strong core, and strong back muscles," says Eisenberg. "Keep your spine in good alignment to prevent worsening of this disease."

Knowing about the impact of facet arthropathy can help you prevent complications.

Bone spurs

When your cartilage and fluid-filled capsules wear down as a result of facet arthrosis, your bones can start touching directly. They can rub together, which can be very painful. And you can get what's called bone spurs.

The outer parts of your bones are normally smooth because your cartilage protects them. But without the cartilage, the friction can lead to rough places where your bones rub together. This doesn't usually cause pain, but if the little bone spurs touch a nerve, you can feel pain.

Enlargement of the joints

After you lose cartilage in your facet joints, your bones try to repair themselves. They try to remodel and grow. This can lead to thicker joints and ligaments (supporting tissues) — also called sclerosis. And this causes bigger (enlarged) joints.

Spinal stenosis 

The enlarged joints with facet arthrosis can also cause the joint to get smaller. As the bone remodels and gets bigger, the joint space around your spinal cord can get tinier. This is called stenosis (narrowing). 

When your spinal canal narrows, it can cause your nerves to get:

  • Irritated
  • Painful 
  • Numb
  • Weak
  • Burn

Disk degeneration

When the disks between the vertebrae of your spine weaken, they can get thinner. The space between your vertebrae gets smaller when you sit or stand up. And this can add pressure on your facet joints.

Spondylolisthesis

This condition happens when a vertebra slips out of alignment, typically forward. Once your vertebrae are out of joint, the bones can press into the vertebra below it. This can squeeze your spinal nerve and lead to pain. Your spinal joint can also slip backward — this condition is called retrolisthesis.

Your doctor will likely ask you about your symptoms and review your medical history. They may ask questions about your pain, how long it lasts, what makes it worse, and point to your spinal pain. Next, your doctor will check for signs and symptoms of nerve problems. After your exam, they may diagnose you with facet arthropathy.

Imaging scans

Imaging tests can help your doctor see if facet arthrosis has caused any visible damage to your joints and nearby tissue.‌

Your doctor may order:

  • MRI
  • X-rays
  • CT scan

Your doctor may also order your X-ray or CT scan with a special dye called a myelogram. This dye goes into your spinal column to help your doctor see if your disk is herniated.

Nerve conduction study and electromyography test 

The nerve conduction and electromyography tests can check the electric signals in your nerves and muscles. These tests tell your doctor if you have any damaged or squeezed nerves.

Diagnostic medial branch block

If it's still unclear, your doctor can use a diagnostic injection to figure out if your facet joint is causing pain. It's a reliable way to confirm your diagnosis.

Medial branch blocks involve injecting pain medicine near the medial branch nerves. These nerves send pain signals from your facet joints to your brain but your doctor can inject pain medicine to block it. If your pain disappears, you likely have facet joint arthrosis. 

Another test injects steroids into the facet joints to see if it lowers your inflammation and pain. If the injection works, you probably have the condition.

Medication can ease your pain and physical therapy helps strengthen muscles. Your exercises can also help lower stress, inflammation, and improve your overall well-being.

To ease pain, you may also try:

Your doctor may talk to you about reaching your goal weight, quitting smoking, and eating a balanced diet.

Injection procedures

If these treatments don't work for you, your doctor may suggest other options such as:

Injection procedures are short-term treatments and in serious cases, your doctor may suggest surgery.

Surgery for facet joints

Although most people don't need surgery, it can help prevent damage to the nerves in your spine. If other treatments aren't working, your doctor may suggest a spinal fusion to keep your facet joints in place and stop them from rubbing together. 

Your surgeon may perform one of these procedures:

  • Transforaminal lumbar interbody fusion (TLIF): Your spine is accessed from your back.
  • Anterior lumbar interbody fusion (ALIF): Your spine is accessed from your belly.
  • Posterior lumbar interbody fusion (PLIF): Your spine is accessed from your back.

Facet arthrosis is osteoarthritis that occurs in the facet joints of your spine. Facet arthropathy often happens as you get older, or after an injury or trauma to your spine. Your back pain may feel worse when you twist, stand, or stretch your back. Talk to your doctor about the best treatment plan for your facet joint arthrosis.

What core strengthening exercises should you do for facet arthrosis?

Pelvic tilts can help with low back pain and strengthen your core. To do pelvic tilts:

  • Lie flat on your back on a flat surface, keeping your feet flat on the floor with your knees bent.
  • Keep your spine and pelvis steady and flatten your back onto the floor.
  • Engage your core muscles, gently pulling your stomach muscles toward your spine.
  • Hold and breathe as usual for 10 seconds. 
  • Relax for two to three seconds and repeat 10 times.

Complete two or three sets with short rests between your sets.

What is the difference between facet arthrosis and arthritis?

Facet arthrosis is osteoarthritis caused by wear and tear to the cartilage in your facet joints. But arthritis is inflammation in your facet joints caused by many different medical conditions.

Can facet arthrosis cause sciatica?

Yes, facet arthrosis can inflame and irritate the sciatica nerve — it runs from your lower back down into your leg. Your condition can lead to instability and irritation in nearby spinal nerves that refer pain to your sciatica.