Lower back pain / Patient guide
A diagnosis is a starting point, not the whole story.
Been told your back pain could be coming from a facet joint? Learn what these small spinal joints do, what the label can—and can't—tell you, and how physiotherapy can help you move forward.
When someone says you have “facet joint pain” or “facet arthritis”, it's understandable to wonder whether your spine is wearing out—and whether bending, twisting or exercising is making things worse.
Those labels can sound alarming. The reality is more nuanced. Your lumbar facet joints are normal parts of your lower back. They can be one possible source of pain, but the presence of joint changes does not automatically explain your symptoms or determine what treatment you need.
What are the lumbar facet joints?
Facet joints are small paired joints at the back of your spine. Along with the discs and other supporting structures, they help guide and control movement between the vertebrae.
Like other joints, they have cartilage, a joint capsule and nerve supply. Changes can occur over time, sometimes described on imaging reports as facet arthropathy, facet degeneration or facet osteoarthritis.
Facet joint changes
A description of what a joint looks like on an X-ray, CT or MRI. These changes are often associated with ageing and may be present without symptoms.
Facet joint-related pain
A clinical possibility that a facet joint is contributing to someone's symptoms. It takes more than a scan or one painful movement to support this explanation.
Changes seen on imaging need to be considered alongside your symptoms, history and how you move and function. Your treatment and rehabilitation plan should be guided by your individual needs and goals - not just the wording in a scan report.
Understanding your symptoms
What might facet joint-related pain feel like?
People thought to have facet joint-related pain may describe several of the following experiences. None of these symptoms, on their own, confirms that a facet joint is the cause.
Aching in the lower back
Pain may be felt on one or both sides of the lower back, although many other types of back pain can feel similar.
Discomfort towards the buttock or thigh
Some people experience pain extending beyond the lower back. Pain location alone cannot reliably distinguish facet joints from other possible sources.
Discomfort with turning or arching
Standing, twisting or extending the back may aggravate symptoms for some people. These movements are not specific diagnostic tests for facet pain.
Changes in activity tolerance
Walking, standing, sport, work or ordinary household tasks may be affected. What matters clinically is how symptoms relate to your individual activities and goals.
If your main symptoms are shooting pain, tingling, numbness or weakness travelling down the leg, another assessment pathway may be important. Our article on sciatica and pain travelling down the leg explains why leg symptoms need their own consideration.
Understanding the diagnosis
How is lumbar facet joint pain diagnosed?
It isn't always possible to pinpoint the exact structure responsible for lower-back pain—and that does not mean your symptoms aren't real.
- 1Your story matters
A physiotherapist considers when the pain began, how it behaves, any leg or nerve symptoms, your medical history, daily activities and what you want to get back to.
- 2Movement tests provide context
Assessment may include bending, turning, walking, lifting, strength and neurological testing where relevant. These help guide care but cannot prove one facet joint is painful.
- 3Scans have limits
Facet arthritis or degeneration on MRI, CT or X-ray may be unrelated to your pain. Imaging is generally reserved for situations where findings could change management.
- 4A working explanation can evolve
Clinicians can assess for other causes or concerning features, agree on an appropriate plan and reassess as your symptoms and function change.
In selected people with ongoing symptoms, a specialist may consider an image-guided diagnostic nerve block as part of assessing whether facet joints contribute to pain. This is not a routine first step for everyone and doesn't replace a broader clinical assessment.
Individualised care in Booragoon
How can physiotherapy help with suspected facet joint pain?
Physiotherapy doesn't have to depend on proving that one particular joint is responsible. A useful plan starts with what you're experiencing, how it affects your life and what you'd like to do more comfortably or confidently.
At Adaptive Physiotherapy & Massage in Booragoon, we assess before deciding what support is appropriate.
Assess
Explore your pain history, symptoms, movement, function and goals. Look for warning signs or neurological symptoms that need medical input.
Individualise
Choose education, activity advice, targeted exercise and appropriate symptom-management strategies based on your presentation—not a fixed “facet joint protocol”.
Guide, progress & reassess
Work towards walking, lifting, work, training or sport. Progress gradually and adjust the plan as your tolerance and goals change.
Practical treatment options
Can exercise and remedial massage help?
Depending on your circumstances, treatment may combine ways to make symptoms more manageable with a plan to maintain or rebuild your ability to move. Not everyone needs the same services or treatment intensity.
Physio-guided exercise
Walking, mobility work, strengthening and gradually returning to activities can support function and confidence. There is no one “facet exercise” that everyone needs, and exercise should reflect your starting point.
Explore Physio-Guided Exercise & Strength TrainingRemedial massage
Massage may be useful for short-term comfort, muscular tension or relaxation. It can be a valid choice based on your preferences; for ongoing back-pain management, it is best considered alongside staying active and other appropriate care.
Explore Remedial Massage in BooragoonIf the idea of exercise makes you apprehensive, our guide on returning to exercise with lower-back pain is another useful starting point.
The Adaptive approach
Movement. Strength. Recovery.
The question isn't only, “Which joint might be sore?” It's also, “What do you want to be able to do, and what would help you get there?” Our three connected principles can guide that conversation.
Movement
Maintain and build comfortable, confident movement for your daily activities, work and recreation.
Strength
Develop the physical capacity to manage the demands that matter to you, through appropriate progressive exercise.
Recovery
Manage flare-ups, adapt activity when needed and support your return to participation over time.
We don't assume everyone needs gym training or massage. Find out more about the Adaptive approach to Movement, Strength and Recovery.
Safety and next steps
When should lower-back pain be checked?
Many episodes of lower-back pain improve with appropriate advice and management, but new, changing or concerning symptoms deserve attention. A label like “facet joint pain” should never prevent assessment for other possible explanations.
If pain is persistent, worsening, limiting your usual life or not responding as expected, a clinician can reassess whether the current plan is suitable and whether further medical review is needed.
Seek urgent medical care for warning signs
New loss of bladder or bowel control, numbness around the groin or between the legs, or significant or rapidly worsening leg weakness require emergency assessment. Seek prompt medical assessment for symptoms such as fever with back pain, major trauma or other concerning changes—especially if you have a relevant medical history.
Common questions
Frequently asked questions
Does facet arthritis on an MRI mean it's causing my pain?
No. A scan can identify joint changes but cannot, on its own, establish that these changes are causing your symptoms. Your clinical history and assessment remain important.
Can a physio test tell me exactly which facet joint hurts?
No single physical examination manoeuvre reliably identifies a painful lumbar facet joint. Assessment is still valuable for understanding your symptoms, function, possible alternative causes and suitable treatment options.
Should I avoid twisting or bending backwards?
Not automatically. Those movements may aggravate symptoms for some people, particularly during a flare-up, but that doesn't make them universally harmful. Your activity can be adjusted and reintroduced according to your response and goals.
Will I need an injection or surgery?
Most people with lower-back pain do not start with invasive procedures. In selected persistent cases a specialist may discuss diagnostic blocks or other interventions. Decisions depend on the full clinical picture and are separate from routine physiotherapy care.
Can massage help if facet joints are involved?
Massage may help with short-term comfort or muscle tension for some people. It cannot confirm or “realign” a painful facet joint and isn't a guaranteed long-term solution. Activity and exercise remain important considerations.
Can I still build strength?
Often yes, with an individualised approach. Depending on your symptoms and other health factors, a clinician can help identify manageable starting exercises and gradually progress your capacity.
Adaptive Physiotherapy & Massage · 27 Shields Crescent, Booragoon WA 6154 · (08) 9468 3555 · Free onsite parking. One physical clinic in Booragoon.
Clinical references and article information
This general patient education article does not replace assessment or individual medical advice. Clinical review and publication date to be completed before the article goes live.