Facet joint pain comes from the small paired joints at the back of the neck that guide and limit movement. When they become irritated, after an awkward movement, a whiplash injury or with age-related change, they cause a one-sided ache and stiffness that can spread to the shoulder blade or the back of the head. It usually settles with movement, exercise and time, and it does not cause numbness or weakness in the arm.
Also known as cervical facet syndrome, zygapophyseal joint pain, facet joint sprain
Symptoms
- A one-sided ache in the neck
- Pain when looking up, turning or tilting the head towards the sore side
- Stiffness, often worse first thing in the morning
- An ache that spreads to the top of the shoulder, the shoulder blade or the back of the head
- Tenderness to pressure at the side of the neck
- No pins and needles, numbness or weakness in the arm
Causes and risk factors
- Age-related changes in the joints
- A whiplash injury
- A sudden awkward movement, or sleeping in an awkward position
- Long spells looking upwards, such as painting a ceiling
- A previous neck injury
What the evidence says helps
- Scans and examination cannot prove that a facet joint is the source. That can only be confirmed with a diagnostic injection, which most people do not need.1
- Each joint refers pain to a recognisable area of the neck, shoulder or head, which helps a clinician judge which level is involved.2
- Clinical guidelines for neck pain with stiffness recommend neck and upper back mobilisation or manipulation combined with exercise.3
- A Cochrane review found that manipulation and mobilisation gave similar results to each other for neck pain. The overall quality of the evidence was low to moderate.4
- For severe, persistent pain confirmed by diagnostic injections, a specialist procedure that interrupts the nerve to the joint gave lasting relief in a small randomised trial.5
Things you can try at home
- Keep the neck moving gently within comfort, and avoid holding it still
- Use heat to ease stiffness
- Adjust your pillow so that your neck is level when lying on your side
- Limit long periods looking upwards until it settles
- Ask a pharmacist about short-term pain relief
- Return to normal activity gradually over days to weeks
When to get urgent help
Contact your GP urgently, call NHS 111, or call 999 in an emergency if you have:
- Neck pain after a fall, a road accident or a blow to the head: go to A&E
- Numbness, weakness or clumsiness in the arms or legs, or difficulty walking: see a GP urgently, or call 999 if it comes on suddenly
- Neck pain with a fever, a severe headache or feeling very unwell: call NHS 111 or 999
- Constant pain that is worse at night, with unexplained weight loss or a history of cancer: see your GP
How Apollo can help
We examine how your neck moves and which joints and muscles are sensitive, and we check the nerves to your arms. Treatment may include mobilisation of the stiff joints, soft tissue work and, where it is appropriate and you are happy with it, manipulation. You will be given exercises to restore movement and build strength so that the improvement lasts. If you develop arm symptoms or do not improve as expected, we will refer you to your GP.
No GP referral needed. Clinics in Sheringham, Coltishall and Norwich.
Related reading
Frequently asked questions
How is facet joint pain different from a trapped nerve?
Facet joint pain is an ache in the neck that can spread to the shoulder blade or head, and it is worse with certain neck movements. A trapped nerve causes pain, tingling, numbness or weakness travelling down the arm, often into the hand.
How long does neck facet joint pain last?
A sudden episode usually eases over a few days to a few weeks. Pain linked to age-related joint change can come and go over a longer period and tends to respond to regular movement and strengthening.
Is neck manipulation necessary?
No. Research suggests that gentler mobilisation gives similar results to manipulation for neck pain, and exercise matters for the longer term. Your practitioner should explain the options, benefits and risks so that you can choose.
References
- Manchikanti L, Boswell MV, Singh V, Pampati V, Damron KS, Beyer CD (2004). Prevalence of facet joint pain in chronic spinal pain of cervical, thoracic, and lumbar regions. BMC Musculoskeletal Disorders 5. View source
- Cooper G, Bailey B, Bogduk N (2007). Cervical Zygapophysial Joint Pain Maps. Pain Medicine 8:344-353. View source
- Blanpied PR, et al. (2017). Neck Pain: Revision 2017. Journal of Orthopaedic & Sports Physical Therapy 47:A1-A83. View source
- Gross A, et al. (2015). Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment. Cochrane Database of Systematic Reviews 2015. View source
- Lord SM, Barnsley L, Wallis BJ, McDonald GJ, Bogduk N (1996). Percutaneous Radio-Frequency Neurotomy for Chronic Cervical Zygapophyseal-Joint Pain. New England Journal of Medicine 335:1721-1726. View source
This page is general information, not a diagnosis or a substitute for medical advice. If you are worried about your symptoms, speak to your GP or a registered healthcare professional. Content prepared from the sources above, November 2026.
