Low Back & Pelvis

What It Is

The spine has a number of bones that are referred to as vertebrae. Every vertebra connects to the vertebra above and below it by the facet joints on both sides of the spine. The facet joints mainly guide and limit the movement of the spine (Won and Kim, 2025).

The facet joints are synovial joints: the bony joint surfaces are covered with smooth cartilage and lubricated by fluid, and a capsule of strong connective tissue wraps around the joint to support it (Hellinga et al., 2025). During certain spinal movements, compression and stretching forces are placed on the facets. If the joint capsule is overstretched, it can become painful (Won and Kim, 2025). Facet joint pain can follow an injury such as whiplash, or come from age-related wear and tear (Hellinga et al., 2025). It might involve a joint sprain, ligament sprain, inflammation, or in more severe cases cartilage damage.

How Do I Know If I Have a Facet Joint Sprain?

One of the most common causes of neck pain in general is the neck becoming locked in an awkward position while sleeping; bad posture and injuries are other common causes (NHS, 2023). The sufferer may wake with neck pain which worsens through the day. The pain can be severe, with muscle spasm and stiffness, and the sufferer may be unable to turn or rotate their neck (Won and Kim, 2025). Sometimes a facet joint sprain is also known as facet joint syndrome. Most neck pain only lasts a few weeks (NHS, 2023).

Cervical Facet Joint Sprain Anatomy

The facet joint is the joint between two vertebrae. There are two facet joints at each level of the spine, one on the left and one on the right. These two facets join with the vertebra above. Joining the vertebrae together forms the spinal column, which houses the spinal cord. From the spinal cord in the neck run the nerves which go to the arms.

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat a Cervical Facet Joint Sprain

Most cases improve with non-surgical care (Won and Kim, 2025). Exercise, a gradual return to activity and range-of-motion exercises are the first-line treatment for facet joint pain (Hellinga et al., 2025). I can guide you through these, with gentle hands-on work alongside to ease stiffness and muscle spasm. See the My Approach tab for how I work.

Self-Help

The NHS (2023) suggests you

use a low, firm pillow
put heat or cold packs on your neck: a pack of frozen peas wrapped in a tea towel for 5 minutes, 3 times a day, or a hot water bottle wrapped in a tea towel for 20 minutes, 2 to 3 times a day
try neck flexibility exercises
do not wear a neck collar, as it is better to keep your neck moving (unless a doctor tells you otherwise)
do not do anything that could be dangerous because you cannot move your neck, such as driving or cycling

Treatments you may want to discuss with your family doctor or nurse practitioner

Options outside my scope

Radiofrequency treatment: if exercise-based care has not helped, a specialist may consider a procedure called medial branch radiofrequency treatment, which targets the small nerves that carry pain from the facet joints (Hellinga et al., 2025).
Steroid injections and surgery: recent guidance does not recommend steroid injections into the facet joint, because there is not enough evidence that they work, and surgery is not recommended for facet joint pain (Hellinga et al., 2025).

How I can help (see the My Approach tab)

Gentle hands-on work and joint mobilisation for the neck and upper back
A graded neck exercise programme
Advice on your pillow, sleeping position and desk set-up

Tips

Make sure to maintain good posture to avoid putting undue pressure on the facet joints. Do not keep your neck in the same position for a long time, for example when sitting at a desk (NHS, 2023).
An inactive (sedentary) lifestyle is one of several risk factors for neck pain (Hellinga et al., 2025).
When lifting an object, it is important that you follow the proper steps to avoid injuring yourself in the process.
When sleeping, keep your head at the same height as the rest of your body, and avoid sleeping on your front or twisting your neck in bed (NHS, 2023).
Maintaining a healthy weight will help your joints and muscles to stay in shape.
Exercising regularly will help to promote muscle stability and enhance your core.

Treatment

My Approach

A facet joint sprain can leave your neck feeling locked, sore and guarded, but most neck pain does best with gentle movement rather than rest. My aim is to settle the pain and muscle spasm, get the stiff joints moving again, and build the strength your neck needs.

If it's a mild sprain, such as waking with a stiff, sore neck after sleeping awkwardly, with no weakness in your arm, I can treat it directly.

If it followed a car accident, a fall or another significant injury, or you have numbness, pins and needles or weakness in your arm that's getting worse, see your family doctor or nurse practitioner first. Once you've been checked, I provide supportive care that fits around their advice, keeping the work gentle.

I start by assessing how your neck and upper back move, what brings on the pain, and the nerves to your arms (sensation, reflexes and strength), so we know which path applies.

When It's Sore

Gentle soft tissue work for the guarding muscles in the neck, upper back and around the shoulder blades, with your head well supported
Warm or cool applications in the clinic, and I'll show you how to use heat or ice safely at home
Gentle, pain-free neck movement, with breathing and relaxation to ease the guarding
Pillow and sleeping-position advice

As It Settles

Gentle, low-velocity joint mobilisation for stiff segments in the neck and mid-back, never quick thrusts
Trigger point and myofascial work, then gentle stretching once the guarding has eased
The deep neck flexor nod: a small "yes" nod lying down, held for up to ten seconds, building to holding your neck steady while you raise your arms
Strengthening for the muscles between and below the shoulder blades, with a home programme
Desk set-up and regular breaks to move your neck

If you notice clumsy hands, trouble walking, or arm symptoms that are getting worse, stop and see your family doctor or nurse practitioner.

What to Expect

Typical Course

Typical course: For a mild sprain, most people come once or twice a week at first, then weekly, spacing visits out as they manage more on their own, and most neck pain settles within a few weeks. If you needed medical care first, expect a longer recovery, often a few months, with weekly visits once you're cleared and a reassessment at about 4 to 6 weeks.

What I Focus On

Assessment & Nerve Screening

Muscle Spasm Relief

Gentle Joint Mobilisation

Deep Neck Strength

Sleep & Desk Habits

Please read

When to See a Doctor First

When to See Your Family Doctor or Nurse Practitioner

See your family doctor or nurse practitioner if neck pain or stiffness does not go away after a few weeks, you are worried about the pain, or you have other symptoms such as pins and needles or a cold arm (NHS, 2023).

Sources

References

Hellinga, M.D. et al. (2025) '7. Cervical facet pain: degenerative alterations and whiplash-associated disorder', Pain Practice, 25(2), e70005. doi: 10.1111/papr.70005
Won, H.S. and Kim, Y.D. (2025) 'Cervical facet joint interventions for neck pain: an anatomically and clinically focused review', Anesthesia and Pain Medicine, 20(4), pp. 329–340. doi: 10.17085/apm.25378
NHS (2023) Neck pain. Available at: https://www.nhs.uk/symptoms/neck-pain-and-stiff-neck/ (Accessed: 7 October 2026).

Massage therapy · Kitchener–WaterlooCervical Facet Joint Sprain

What It Is

How Do I Know If I Have a Facet Joint Sprain?

Cervical Facet Joint Sprain Anatomy

Self-Care & Treatment

How to Treat a Cervical Facet Joint Sprain

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

When It's Sore

As It Settles

Typical Course

When to See a Doctor First

When to See Your Family Doctor or Nurse Practitioner

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooCervical Facet Joint Sprain

What It Is

How Do I Know If I Have a Facet Joint Sprain?

Cervical Facet Joint Sprain Anatomy

Self-Care & Treatment

How to Treat a Cervical Facet Joint Sprain

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

When It's Sore

As It Settles

Typical Course

When to See a Doctor First

When to See Your Family Doctor or Nurse Practitioner

References

Related Conditions

Oblique Muscle Strain

Rectus Abdominis Strain

Acute Back Pain

Cervical Disc Herniation

Book a session