70) Facet Joint Injuries: How Physiotherapy Heals Your Spine Naturally
Facet joint injuries occur when the small joints between vertebrae become irritated, damaged or stiff, causing pain, limited movement and sometimes referred pain into other areas. Physiotherapy provides hands-on treatment, posture correction and strengthening to calm inflammation and restore function. Read on to discover how you can recover fully—and fast
What Are Facet Joints & Why They Matter
Facet joints (also called zygapophyseal or “Z-joints”) are pairs of small joints at the back of each vertebra. They help your spine move (twist, flex, extend) and stabilise it so the vertebrae don’t slide. When they’re happy, you can bend, turn your neck or back without pain. When injured, though, they can be a major source of agony.
What Causes a Facet Joint Injury
Facet joint injuries stem from a variety of causes:
- Sudden trauma (whiplash, falls) that overstretches or compresses the joint.
- Repetitive strain or overuse (e.g. frequent twisting, poor lifting technique) that causes micro-trauma over time.
- Degeneration (arthritis, cartilage wear) leading to stiffness, inflammation and pain.
- Poor posture that overloads facets, especially with prolonged sitting or standing.
Symptoms You Might Notice
If a facet joint is injured, you may experience:
- Localised pain (neck, mid-back, or lower back) that worsens with movement, bending backwards, twisting.
- Stiffness, especially after rest or first thing in the morning.
- Pain referred to nearby areas: buttocks, hips, thighs, shoulders depending on the joint involved.
- Reduced range of motion and sometimes muscle spasms / guarding around the joint.
If your symptoms don’t match up, it could be the disc. Read more HERE
How Physiotherapy Helps: What You Can Expect
Physiotherapy is one of the best non-surgical treatments for facet joint injuries. It works at multiple levels:
- Hands-on manual therapy – mobilisations or joint release techniques to reduce stiffness, improve joint glides, relieve pain.
- Targeted exercise programs – to strengthen the core and stabiliser muscles of the spine; improve flexibility of surrounding tissues; retrain movement patterns.
- Posture education & ergonomic advice – changing how you sit, sleep, lift, work can reduce ongoing stress on facet joints.
- Pain relief modalities – heat/cold therapy, taping, possibly soft-tissue massage to reduce inflammation, muscle spasm and improve comfort.
- Dry Needling – Some cases require a deeper release of muscle tone and dry needling can help with this
- Gradual progression – from gentle movement to more challenging functional activities so that you can return to daily tasks, sports or work.
Evidence & Best Practice
- Facet joint injuries / facet joint syndrome account for a significant portion of chronic back pain (lumbar facet joints especially), with estimates varying around 15-40% depending on the population studied.
- Systematic reviews show that physiotherapy (manual therapy + exercise) helps reduce pain and improve function in acute, sub-acute and chronic phases.
- Some interventional procedures (e.g. injections, radiofrequency ablation) are options when conservative management fails, but physiotherapy remains the foundation.
Case Study: Real Patient from Our Clinic
Let me tell you about Dave, who came to our clinic from a surrounding suburb near Frenchs Forest, NSW. Dave is in his mid-40s, works in landscaping, and developed sharp lower back pain that got significantly worse when he twisted or leaning backwards. He also had stiffness first thing in the morning, and occasional referral down into his buttocks.
After assessment, we determined the issue was a lumbar facet joint injury — one side more affected. Our treatment plan included:
- Gentle mobilisation of the lumbar facet joint (manual therapy)
- Core and glute strength exercises, hip mobility work
- Posture and lifting technique coaching
- Heat + soft-tissue work for muscle spasm
Within 4 weeks Dave reported a 70-80% reduction in pain, improved ability to bend and twist with less discomfort, and by 8 weeks he was back doing most of his landscaping tasks with confidence. By week 12, he was almost pain-free doing gym, lifting and daily duties.
This example shows that with the right approach, consistent physiotherapy yields outcomes sooner than many expect.
Treatment Timeline: What to Expect Week by Week
| Phase | Typical Goals | What Physiotherapy Does |
|---|---|---|
| Weeks 1–2 (Acute) | Reduce pain and inflammation, protect the joint, reduce spasm | Rest, gentle manual therapy, pain relief modalities, teaching safe movement, minimising aggravating postures. |
| Weeks 3–6 (Sub-acute) | Restore range of motion, begin gentle strengthening | More mobility exercises, core/glute/hip control work, gradual loading, more manual therapy to unlock stiff joints. |
| Weeks 7–12+ (Recovery / Long-term) | Return to full activity, prevent recurrence | Functional exercises, sport/work-specific training, maintenance program, ongoing postural / ergonomic guidance. |
Tips You Can Use Today to Help Your Facet Joint
- Take breaks from sitting; move frequently and avoid sustained awkward postures.
- Use heat to ease stiffness before activity, cold after high pain flares if swollen.
- Practice core-activation (pelvic tilts, gentle bridging) to support spine.
- Sleep positions: side-lying with a pillow between knees helps lumbar facet stress; use lumbar support in seating.
- Avoid extreme extension/backwards bending until the joint feels more stable.
Potential Ideas When Standard Physio Isn’t Enough
If after around 8-12 weeks of good physiotherapy you still have significant pain / disability, your clinician might consider:
- Diagnostic facet joint blocks to confirm the pain source. Pain Physician+1
- Medial branch blocks or radiofrequency ablation to reduce pain signalling. Pain Physician+2SpringerLink+2
- Intra-articular steroid injections (depending on cases). ScienceDirect+1
Prevention: Keeping Facet Joints Healthy
- Strong core and stabiliser muscles around spine and pelvis.
- Regular mobility work for hips, thoracic spine (mid back) so lumbar or cervical facets aren’t overloaded.
- Good ergonomics at work and home (sitting, standing, lifting).
- Avoid carrying heavy loads on one side, twisting awkwardly.
- Maintain healthy weight; obesity increases load on spinal joints.
Strong Hook & Why You Need to Act Now
Neglecting a facet joint injury can lead to chronic stiffness, reduced motion, and persistent pain that limits work, play and daily life. The sooner you get proper assessment and physiotherapy, the faster you reclaim your mobility and reduce risk of recurring flare-ups.
Call to Action
Ready to get relief and restore strength in your spine? Don’t wait for the pain to worsen— give us a call today on 9806 3077 or book online, just CLICK HERE and let’s start your journey to feeling better.
References & Further Reading
- Physiopedia. “Facet Joint Syndrome” – overview of symptoms, anatomy and treatment options. Physiopedia
- Vitalis Physiotherapy. “Facet Joint Pain” – causes, treatments, posture ideas. vitalisphysiotherapy.com.au
- The Pain Physician Journal – Guidelines for facet joint interventions. Pain Physician
- PhysioWorks! “Facet Joint Arthropathy” – descriptions of hypomobility and hypermobility and how physio helps.
