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Causes of Facet Joint Syndrome

The spine is kept strong and flexible by the vertebrae, each of which is a movable structure composed of three joints: an intervertebral disc joint and two facet joints (also known as zygapophyseal joints). 

Each facet joint is lined with cartilage, which is a soft cushioning structure that prevents the bones from rubbing against each other during movement while keeping the joint lubricated. In facet joint syndrome, the cartilage begins to deteriorate, leaving the bones exposed to friction and shock damage.

These degenerative changes lead to pain, inflammation, and reduced range of motion. They also cause body weight to be distributed unevenly during movements, which may result in mechanical issues, back problems, and poor posture. 

Generally, this condition is the result of a combination of risk factors. Let’s look at these in more depth below.


Aging involves a natural loss of cartilage and synovial fluid – the thick liquid that encapsulates synovial joints, like facet joints. As cartilage begins to deteriorate, the joint’s components may begin to rub against each other, which can lead to irritation, pain, or mechanical problems. 

Facet joint syndrome due to aging mainly affects the lumbar spine, making it one of the main causes of lower back pain in older adults. 

Repetitive Stress

Repeated stress and forceful movements can cause the cartilage to break down faster than it should, especially in certain areas affected by the hyperextension of the spine’s components. Some sports and activities that may cause facet joint syndrome include pitching and throwing. 

Trauma and Injuries

Direct trauma or injuries, such as the whiplash from a car accident, may damage the components that keep the vertebrae healthy, including supporting ligaments and the intervertebral disc. 

In turn, misalignments and mechanical problems can cause the degeneration of the facet joint’s cartilage. It is estimated that cervical facet joint syndrome arises in 29-60% of whiplash injuries cases. 

Poor Posture

Poor posture can put excessive stress on certain components of the joint and cause body weight to be distributed unevenly over the joint’s cartilage. This may lead to further deterioration of the cartilage in one or more areas, thus leading to pain, irritation, or damage to the joint’s components. 


Obesity may cause overload of the spine during movement, which can lead to the deterioration of the vertebral disc (a disc of cartilage between the vertebrae). When the damaged vertebrae are unable to support the body’s weight, this shifts towards the adjacent components, which are the facet joints. 

This excessive stress can then lead to the breakdown of the cartilage between the facet joint’s components and cause the bones to start rubbing against each other. 

Genetics and Hereditary Factors

If you have a family history of facet joint syndrome or you suffer from malformations of the cartilage, you might be at greater risk of developing this condition. Additionally, inflammatory diseases such as arthritis can make the degeneration of the facet joint’s cartilage more likely.

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Symptoms of Facet Joint Syndrome

Facet joints play a critical role in enabling movements of the spine, including flexion, extension, and rotational movements. When the cartilage between the joint’s components breaks down, you might begin to experience pain during movements such as bending, sitting, or twisting your torso. 

Depending on the location of the facet joints affected by this condition, you might suffer from cervical (near the neck), thoracic (in the torso area), or lumbar (lower back) facet joint syndrome. Most commonly, this condition affects the L4 and L5 spinal segments, which are located in the lower lumbar spine. 

The symptoms will be localized in the areas affected by facet joint degeneration, but the pain and discomfort can continue to spread further as the disease progresses. Although facet joint syndrome might be painless at first, it is important to understand what telltale signs to look for to find adequate treatment as soon as possible. Let’s look at these below.


One of the symptoms most commonly associated with facet joint syndrome is pain. Painful sensations begin in the areas affected by joint degeneration and can be triggered by health events such as injuries. 

Over time, the sensation of pain begins to spread through the spine, across the buttocks, or to the neck and shoulder area. This pain is often described as dull or aching, and may mimic the discomfort caused by a disc herniation.

Reduced Range of Motion

When the cartilage between the facet joint’s components breaks down, the bones can begin to rub against each other and cause misalignments with other joint components, such as ligaments and tendons. Over time, this can prevent you from performing movements such as bending and twisting, and can significantly impact your level of flexibility.

Nerve Damage and Nerve Pain 

Misalignments in the facet joints caused by a breakdown of the cartilage can cause bones to pinch and press on spinal nerves. In turn, damaged nerves can misfire and send abnormal signals to the brain, leading to burning sensations, muscle spasms, and cramps.

Bone Spurs 

In an attempt to heal the deteriorating cartilage, the body builds up new material in the area damaged by facet joint syndrome. Over time, this can lead to bony growths attached to the joint’s bones, known as bone spurs. These can further restrict your spine’s range of movement and lead to radiating pain.

Regenerative Treatment Options for Facet Joint Syndrome

Pain relievers, non-steroidal anti-inflammatory drugs (NSAIDs), and steroid injections are some of the most common treatments prescribed for facet joint syndrome. However, given the degenerative nature of this condition, it is important for patients to look for treatment options that go beyond simply addressing the pain and discomfort. 

That’s where regenerative treatments can help. At Orthagenex, injections of PRP and BMC are combined to help patients improve their spinal health without surgery. Let’s take a look at these treatment options in more depth.

Super-Concentrated PRP for Facet Joint Syndrome

Platelet-rich plasma (PRP) refers to autologous blood samples that have been processed to have platelet concentrations that are 10-40 times higher than baseline levels using a laboratory setting. The use of PRP in regenerative medicine has received significant interest, due to its ability to deliver high concentrations of growth factors precisely and non-invasively to an area in need.

PRP procedures involve injecting the body’s own healing factors (platelets) into the injured tissue using image guidance with fluoroscopy and MSK ultrasound. This procedure can be used to treat a variety of orthopedic conditions, including joint instability, minor arthritis, ligament, and tendon injuries, and strains.

More than 30 randomized controlled trials have been carried out on the effectiveness of PRP to support the body’s ability to heal naturally by stimulating the stem cells within the targeted area.

Bone Marrow Concentrate Injections for FJS

Stem cells are an essential component of the human body and play an important role in the repair of injured bones, ligaments, tendons, and other tissues. However, when we age or suffer an injury, the body may become unable to deliver enough these cells to the area in need.

To help with this, bone marrow concentrate procedures at Orthagenex use imaging guidance to deliver concentrated bone marrow containing stem cells to the area in need. This encourages the body’s inherent ability to heal itself by replenishing cell population in the injured area.

In practice, bone marrow concentrate procedures are carried out by cannulating the bone near the pelvis with a trocar, a sharp-tipped device. This provides a narrow tunnel that can be used to collect samples of the bone marrow’s liquid component, which is rich in stem cells.

BMC procedures can assist patients in improving their spinal health and mobility without the lengthy and painful rehabilitation periods associated with surgery.



At Orthagenex, we believe in helping each patient find a treatment option that goes beyond simply easing pain in the short term. Thanks to our custom PRP and BMC, we can offer a treatment option that addresses the underlying cause of your condition and provides a pain management strategy that is sustainable in the long term.

If you are ready to improve your spine health and function without surgery, Orthagenex can help.

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