Low Back & Pelvis

What It Is

Facet joints are small paired joints at the back of the spine that link each vertebra (spinal bone) to the one above and the one below (Perolat et al., 2018). The nerve roots leave the spine through openings beside these joints, on their way to the arms, legs and other parts of the body. The facet joints allow the spine to bend forwards and backwards, while limiting twisting and stopping the vertebrae from slipping over each other (Du et al., 2022). Similar to the knee joint, they have cartilage that allows smooth movement where the two bones meet, and they are surrounded by a joint capsule with a lining (synovium) and lubricating joint fluid (Perolat et al., 2018).

When the joints become swollen and painful due to injury or strain, it can cause pain. If the affected joint is in the neck, it can cause neck pain, headaches and trouble moving the head (Hellinga et al., 2025). If the problem is in the lower back, pain can spread into the buttocks and thighs (Perolat et al., 2018).

Facet joint syndrome is sometimes described as a facet joint "locking". The pain can come on suddenly with a simple everyday movement, such as bending or twisting to pick something up, or straightening up again afterwards. Facet joint pain is typically made worse by bending backwards and twisting, and by standing or sitting for long periods, and it is often worse in the morning and after periods of inactivity (Perolat et al., 2018; Du et al., 2022).

Sometimes the pain is so bad that turning over in bed or getting out of bed is very uncomfortable. Even so, try not to stay in bed for long periods: staying active and carrying on with your daily activities as much as you can helps recovery (NHS, 2026). If you can get up and move gently, this is often better.

Facet Joint Syndrome Anatomy

The spine is made up of vertebrae that sit on top of each other to form the vertebral column, connected by pairs of facet joints at each level (Perolat et al., 2018). The spine has three main sections: the neck (cervical spine), which gives the head both stability and movement; the chest area (thoracic spine), which is relatively stiff; and the lower back (lumbar spine), which connects to the pelvis. Facet joint pain can affect the neck, the upper back or the lower back.

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

Treatment

Self-Care & Treatment

How to Treat Facet Joint Syndrome

Exercise is a first-line treatment for facet joint pain in the neck (Hellinga et al., 2025), and NICE recommends exercise programmes for low back pain, with hands-on (manual) therapy such as massage used alongside exercise rather than on its own (National Institute for Health and Care Excellence, 2016). I can give you an exercise programme and hands-on treatment that work together. See the My Approach tab for how I work.

1. Good Posture

Good posture and support for the lower back when driving or sitting in a car is important.

2. Heat or Cold

For heat, you can use a heat pack or hot water bottle wrapped in a tea towel, or a warm shower, to relieve stiffness or muscle spasms. For cold, use an ice pack (or a bag of frozen peas) wrapped in a tea towel to help reduce pain and swelling (NHS, 2026).

3. Caution with Painful Movements

Be careful with the movements that bring on your pain until your symptoms ease. Bending backwards and twisting often make facet joint pain worse (Du et al., 2022), and during a flare-up you may also find bending for household chores, such as making the bed or loading the dishwasher, uncomfortable.

4. Changing Your Routine

Long periods of sitting or standing can make facet joint pain worse (Perolat et al., 2018), so break up long drives, commutes and desk work with frequent breaks to move around and stop your joints becoming stiff. Keep as mobile as you can.

Tips

Pain is often described as sharp, and can occur in the lower back, upper back or neck.
A previous whiplash injury can involve the facet joints in the neck (Hellinga et al., 2025).
Complaints of locking or severe stiffness are common with the syndrome.
How quickly you return to normal activities depends on your individual case and the progress you make.
If you cannot turn without having to turn your entire body from left to right, let me know so I can assess whether your facet joints could be involved.
Maintain good core strength to support your spine. Ask me for core exercises when the pain settles down.
Stay gently mobile: avoid sitting, standing or walking in the same position for long periods without a break.

Treatment

My Approach

Facet joint pain often comes on suddenly and can be very sore, but it usually settles with the right mix of movement, hands-on work and exercise. My aim is to ease the pain and muscle guarding, get your spine moving again, and build the strength and habits that keep it settled.

I start by assessing how your neck or back moves, which movements bring the pain on, your posture, and the strength and flexibility around your spine and hips. I also check your nerves (sensation, reflexes and strength) and ask about the warning signs that need urgent medical care.

When It's Sore

Comfortable, supported positions, often on your side or with your hips and knees bent
Warm applications and relaxing massage to ease the muscles guarding the sore joint
Trigger point and myofascial work through the back, hips and hamstrings, or the neck, shoulders and base of the skull if it's your neck
Gentle, low-velocity mobilisation of stiff spinal segments, and gentle manual traction for the neck if it helps, never quick thrusts or forceful movements
Short walks and easing positions rather than bed rest

As It Settles

Finding which directions ease your symptoms: bending backwards and twisting often aggravate facet joints, so we start with what's comfortable and bring other movements back step by step
Pain-free mobility work, then core strengthening, progressing to bridges, lunges and hip-hinge work
When you're ready, gym-based strength work with weights, with coaching on bending and lifting technique
A home programme, plus posture, desk and driving habits that break up long spells of sitting or standing

Back and neck pain can come back. A flare-up isn't a failure; it's something to manage with a plan you already know.

If you have pain, tingling, numbness or weakness in both legs, numbness around your genitals or bottom, or changes in your bladder or bowels, call 911 or go to the emergency room (see When to Get Urgent Help).

What to Expect

Typical Course

Typical course: Most people come once or twice a week for the first two to three weeks, then weekly for about a month, with a reassessment at about 4 to 6 weeks, then less often as they manage more on their own. Most flare-ups ease noticeably within a few weeks, and many people are back to their normal activities within about six weeks.

What I Focus On

Pain & Spasm Relief

Gentle Spinal Mobilisation

Direction-Guided Exercise

Core & Hip-Hinge Strength

Posture & Daily Habits

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
Du, R., Xu, G., Bai, X. and Li, Z. (2022) 'Facet joint syndrome: pathophysiology, diagnosis, and treatment', Journal of Pain Research, 15, pp. 3689–3710. doi: 10.2147/JPR.S389602
Hellinga, M.D., van Eerd, M., Stojanovic, M.P. et al. (2025) '7. Cervical facet pain: degenerative alterations and whiplash-associated disorder', Pain Practice, 25(2), e70005. doi: 10.1111/papr.70005
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).

Massage therapy · Kitchener–WaterlooFacet Joint Syndrome

What It Is

Facet Joint Syndrome Anatomy

Self-Care & Treatment

How to Treat Facet Joint Syndrome

1. Good Posture

2. Heat or Cold

3. Caution with Painful Movements

4. Changing Your Routine

Tips

My Approach

When It's Sore

As It Settles

Typical Course

When to See a Doctor First

When to Get Urgent Help

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooFacet Joint Syndrome

What It Is

Facet Joint Syndrome Anatomy

Self-Care & Treatment

How to Treat Facet Joint Syndrome

1. Good Posture

2. Heat or Cold

3. Caution with Painful Movements

4. Changing Your Routine

Tips

My Approach

When It's Sore

As It Settles

Typical Course

When to See a Doctor First

When to Get Urgent Help

References

Related Conditions

Acute Back Pain

Cervical Disc Herniation

Cervical Facet Joint Sprain

Cervical Spondylosis

Book a session