Facet joint pain is back pain thought to come from the small joints at the back of the spine, and lumbar spondylosis is the general term for age-related changes in the lower spine. These changes are very common and often cause no pain at all. When they are painful, the approach is usually the same as for other low back pain: staying active and exercise-based care.
Also known as facet joint syndrome, lumbar spondylosis, facet arthritis, spinal osteoarthritis, wear and tear of the spine
Symptoms
- Aching in the lower back, sometimes on one side
- Stiffness, especially in the morning or after rest
- Pain when leaning backwards, twisting or standing for long periods
- Pain that may spread into the buttock or upper thigh, but rarely below the knee
- Pain that eases with movement once warmed up
Causes and risk factors
- Normal age-related changes in the facet joints and discs
- Previous back injury or repeated heavy loading
- Higher body weight
- Reduced activity levels and loss of strength, which can make the back less tolerant of load
What the evidence says helps
- NICE guidance recommends the same foundations as for other low back pain: information, reassurance, staying active and considering exercise, with manual therapy only as part of an exercise package.1
- A large Cochrane review found exercise therapy probably reduces pain in persistent low back pain compared with no treatment or usual care.4
- A BMJ review found spinal manipulation gave effects similar to other recommended therapies for persistent low back pain, with mostly mild, temporary side effects.5
- Facet joint changes on scans are common in people without pain, so scans alone cannot confirm that the facet joints are the source of symptoms.2
- NICE says radiofrequency denervation may be considered for selected people after a positive diagnostic nerve block. However, a large set of trials found it added little or no clinically important benefit over an exercise programme alone.13
Things you can try at home
- Keep moving through the day and avoid staying in one position for too long
- Try gentle mobility exercises in the morning to ease stiffness
- Build strength in the legs, hips and trunk gradually
- Use heat for comfort when stiff
- Stay generally active with walking, swimming or cycling
When to get urgent help
Contact your GP urgently, call NHS 111, or call 999 in an emergency if you have:
- Numbness around your genitals, bottom or inner thighs, or new bladder or bowel problems – go to A&E or call 999 immediately
- Weakness or numbness in both legs – seek urgent medical help
- Back pain after a significant fall, especially if you have osteoporosis – seek urgent medical help
- Back pain with fever or feeling very unwell – contact your GP urgently or NHS 111
- Back pain with unexplained weight loss or a history of cancer – see your GP urgently
- Severe, constant pain at night that does not ease with rest – see your GP urgently
How Apollo can help
We assess how your back moves and what aggravates and eases your pain, and explain what scan findings such as 'wear and tear' do and do not mean. Care is exercise-led, focusing on mobility and strength, with hands-on techniques used alongside this where appropriate. We can support you with supervised clinical exercise, Reformer Pilates and strength testing to track progress.
No GP referral needed. Clinics in Sheringham, Coltishall and Norwich.
Related reading
Frequently asked questions
What does 'wear and tear' on my back scan mean?
It usually describes normal age-related changes in the discs and joints. These are found in many people with no pain at all. They do not mean your back is fragile or that it will keep getting worse.
Is exercise safe with facet joint arthritis?
Yes. Exercise is one of the main recommended approaches for persistent low back pain. Starting gently and building up gradually helps your back become more tolerant of activity.
Do facet joint injections work?
NICE does not recommend spinal injections for low back pain. Radiofrequency denervation may be considered in selected cases after a diagnostic block, but research shows mixed results. This is a discussion to have with your GP or a pain specialist.
References
- National Institute for Health and Care Excellence (2016, updated 2026). Low back pain and sciatica in over 16s: assessment and management (NG59). NICE. View source
- Kalichman L et al. (2008). Facet joint osteoarthritis and low back pain in the community-based population. Spine. View source
- Juch JNS et al. (2017). Effect of radiofrequency denervation on pain intensity among patients with chronic low back pain: the Mint randomized clinical trials. JAMA. View source
- Hayden JA et al. (2021). Exercise therapy for chronic low back pain. Cochrane Database of Systematic Reviews. View source
- Rubinstein SM et al. (2019). Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: systematic review and meta-analysis of randomised controlled trials. BMJ. 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.
