Facet joint pain is one of the most common causes of back discomfort, yet many people don’t know what the facet joints are or why they become sore. Understanding the role these joints play in spinal movement, and how physiotherapy can help, can make recovery faster and prevent future flare-ups.
What Are Facet Joints?
Facet joints, also known as zygapophyseal or “Z-joints,” are small but critical joints located throughout the spine. Each spinal segment has two facet joints, one on the left and one on the right. These joints connect the vertebrae together, linking the superior articular process of one vertebra with the inferior articular process of the one above.
Working alongside spinal discs, ligaments and stabilising muscles, the facet joints help transfer loads and allow smooth motion. They enable you to bend, twist and extend your spine without excessive strain. While facet joints exist from the neck (cervical spine) down to the lower back (lumbar spine), the lumbar region is the most common site of pain and injury.
Common Symptoms of Facet Joint Pain
Facet joint pain can feel different depending on whether it arises suddenly (acute) or gradually (insidious onset).
- Acute pain: Usually feels sharp and localised to one side of the spine. A person may feel a sudden “catch” or sharp twinge, especially when twisting, bending or extending the back.
- Gradual onset pain: Often presents as stiffness, tightness, a sense of “jamming” in the spine, or a dull ache. This discomfort can feel central or one-sided, often worse after long periods of sitting or standing.
People with facet joint irritation may notice difficulty with movements like arching backward, twisting or sitting in the car for long stretches.
Why Do Facet Joints Become Sore?
Facet joint problems can develop either from a specific injury or from accumulated stress over time.
Acute Facet Joint Pain
An acute facet joint sprain typically occurs during a sudden movement such as jumping and landing awkwardly, twisting quickly, or bending backward in an unusual way. The pain is sharp, often one-sided, and aggravated by bending forward, extending backward or twisting. At rest, it may settle into a dull ache but tends to flare with movement in the first few days.
Gradual Onset Facet Joint Pain
Sometimes facet joints don’t become painful overnight. Instead, repetitive loading or prolonged inactivity builds up irritation over weeks. For example, an increase in training, heavy housework or weightlifting can overload the joints. On the flip side, long sedentary periods, such as sitting at a desk or driving for hours can also cause stiffness and irritation.
Symptoms typically include a stiff, jammed feeling in the lower back, with pain increasing during arching or rotation.
Physiotherapy & Other Treatment for Facet Joint Pain
Managing Acute Facet Joint Sprains
- Relative rest: Avoiding total inactivity is crucial. While you should limit strenuous tasks (like heavy lifting or sport), gentle walking and frequent breaks from sitting can help prevent stiffness.
- Medication: Over-the-counter pain relief or anti-inflammatories may be useful but should only be taken under medical advice.
- Short-term relief strategies: Heat packs and gentle forward bending may ease symptoms.
- Physiotherapy: At the acute stage, physiotherapy often focuses on pain relief techniques such as manual therapy, taping and gentle mobility exercises to reduce muscle spasm and restore comfort.
Managing Gradual Onset Pain
- Movement is key: Regular walking, gentle stretching and avoiding prolonged sitting are highly beneficial.
- Mobility exercises: Stretching and mobility work for both the spine and hips help reduce stiffness and restore normal joint function.
- Physiotherapy support: Physiotherapists use hands-on therapy, tailored exercises, and activity advice to gradually increase load tolerance and get patients back to their daily routines or sports.
The dedicated physios at Melbourne Sports Physiotherapy will undertake a thorough examination and determine whether your facet joint pain is acute or gradual. Following their diagnosis they will tailor a treatment plan to best suit the issue and help reduce pain and prevent re-injury.
Preventing Facet Joint Pain
Treatment doesn’t end when the pain subsides. Long-term prevention involves strengthening, mobility and improving load management.
- Strength restoration: Core and spinal strength exercises, such as planks, dead bugs, or goblet squats, help protect the spine. Goals may include maintaining a side plank for 60–90 seconds to ensure adequate endurance.
- Hip strength: Weak hips often contribute to overloading the lower back. Exercises like crab walks, single-leg bridges and banded hip flexion build resilience.
- Biomechanical assessment: Physiotherapists can assess movement patterns, sports techniques or workplace postures that may contribute to repeated overload.
- Load management: Gradual progression in training or activities prevents sudden spikes that irritate the joints.
Why Physiotherapy Can Help
If you are struggling with facet joint pain, you don’t need to put up with it. Physiotherapy offers expert assessment and treatment to not only relieve pain but also identify the root cause. A physiotherapist will work out whether your pain came from overtraining, poor posture or subtle strength imbalances.
Treatment may include:
- Hands-on therapy to release stiff joints and muscles.
- Targeted strengthening and mobility programs.
- Education on safe movement and activity pacing.
- Long-term strategies to prevent recurrences.
By addressing both the symptoms and underlying contributors, physiotherapy helps you return to work, sport and daily life with confidence.
If you’re experiencing sharp, dull, or persistent back pain that feels like tightness or jamming, seeking help from Melbourne Sports Physiotherapy could be the key to regaining mobility and preventing future issues. With expert care and tailored guidance, you can move past pain and back into life. Give them a call or book an appointment online.
