Massage therapy · Kitchener–WaterlooFacet Joint Osteoarthritis
Low Back & Pelvis
What It Is
Lower back pain is very common (NHS, 2026). Pain can range from mild to intense. It can be either short-lived or long-lasting. Regardless of how it happens, lower back pain can make many everyday activities quite difficult to perform.
Osteoarthritis (OA) is often thought of as "wear and tear". As part of normal life, your joints are exposed to a constant low level of damage, and in most cases the body repairs it without any symptoms. In osteoarthritis, the protective cartilage on the ends of the bones breaks down, causing pain, swelling and problems moving the joint (NHS, 2023). The facet joints of the spine can be affected like any other joint. In fact, osteoarthritis is the most common problem affecting the facet joints, and it becomes more common with age (Perolat et al., 2018).
Facet Joint Osteoarthritis Anatomy
What Causes Facet Joint OA?
- Age: the risk of osteoarthritis increases as you get older (NHS, 2023), and facet joint osteoarthritis becomes more common with age (Perolat et al., 2018)
- Wear of the discs between the vertebrae, which is closely linked with facet joint osteoarthritis (Perolat et al., 2018)
- Excessive use or strain: overusing a joint when it has not had enough time to heal after an injury, or exercise or a job that puts frequent strain on the joints (NHS, 2023)
- Being overweight, which puts extra strain on the joints (NHS, 2023)
- Family history: osteoarthritis may run in families (NHS, 2023)
Not a diagnosis — for more information, contact me or another trusted healthcare provider.
Treatment
Self-Care & Treatment
How to Treat Facet Joint Osteoarthritis
Treatments you may want to discuss with your family doctor or nurse practitioner
Tips
- Make sure to lift any heavy items with your legs and not your back.
- Try to keep good posture and avoid staying in the same position for too long. If you work at a desk, make sure your chair is at the correct height and take regular breaks to move around (NHS, 2023).
- Combining aerobic exercise with strengthening exercises will help keep the muscles of your abdomen and back flexible and strong. The NHS suggests at least 150 minutes of moderate aerobic activity (such as cycling or fast walking) every week, plus strength exercises on 2 or more days a week (NHS, 2023).
- Maintaining a healthy weight reduces the strain on your joints (NHS, 2023).
- Stay active and try to carry on with your daily activities. Do not stay in bed for long periods (NHS, 2026).
Treatment
My Approach
As the small joints at the back of the spine wear, the back can become stiff and achy, and the muscles around it often tighten to guard it. My aim is to ease the pain and muscle spasm, keep the stiff parts of your spine moving, and build the strength and habits that help you stay active.
I start by assessing how your back and hips move, which directions ease or bring on your pain, and your strength, posture and the way you sit, stand and lift. If pain spreads into your legs, I also check feeling, reflexes and strength there.
Hands-On Treatment
- Comfortable positions, often on your side or with your knees supported, with warmth and slow breathing to help you relax
- Massage, myofascial and trigger point work through the low back, hips and hamstrings
- Gentle, low-velocity mobilisation of stiff joints and gentle traction by hand, never quick thrusts or fast movements, and never on parts of the spine that are already too loose
- Assisted stretches for tight muscles
Exercise
- Finding the direction of movement that eases your symptoms, and building your home exercises around it
- Pain-free mobility and stretching, then strength for your trunk, hips and legs
- Gym-based progressions when you're ready, including learning to hinge and lift well
Daily Habits
What to Expect
Typical Course
What I Focus On
Please read
When to See a Doctor First
When to Get Urgent Help
Call 911 or go to the emergency room at your nearest hospital if you have back pain and any of the following (NHS, 2026):
- Pain, tingling, weakness or numbness in both legs
- Loss of feeling around your genitals or bottom (anus)
- Changes in your bladder or bowels, such as difficulty peeing, or peeing or pooing yourself
- Changes in how your genitals feel during sex, or problems getting an erection or reaching orgasm
- Chest pain
- Back pain that started after a serious accident, such as a car accident
Do not drive yourself; ask someone to take you or call 911 for an ambulance (NHS, 2026).
Sources
References
- Perolat, R., Kastler, A., Nicot, B. et al. (2018) 'Facet joint syndrome: from diagnosis to interventional management', Insights into Imaging, 9(5), pp. 773–789. doi: 10.1007/s13244-018-0638-x
- NHS (2023) Osteoarthritis. Available at: https://www.nhs.uk/conditions/osteoarthritis/ (Accessed: 7 October 2026).
- NHS (2026) Back pain. Available at: https://www.nhs.uk/conditions/back-pain/ (Accessed: 7 October 2026).
- National Institute for Health and Care Excellence (2016, updated 2026) Low back pain and sciatica in over 16s: assessment and management (NICE guideline NG59). Available at: https://www.nice.org.uk/guidance/ng59/chapter/Recommendations (Accessed: 7 October 2026).