pISSN 2005-9159
eISSN 2093-0569

Review Article

Korean J Pain 2024; 37(1): 3-12

Published online January 1, 2024 https://doi.org/10.3344/kjp.23228

Copyright © The Korean Pain Society.

Facet joint disorders: from diagnosis to treatment

Yeong-Min Yoo and Kyung-Hoon Kim

Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Korea

Correspondence to:Kyung-Hoon Kim
Pain Clinic, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan 50612, Korea
Tel: +82-55-360-1422, Fax: +82-55-360-2149, E-mail: pain@pusan.ac.kr

Handling Editor: Yeon-Dong Kim

Received: July 31, 2023; Revised: October 16, 2023; Accepted: October 19, 2023

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


One of the most common sources of spinal pain syndromes is the facet joints. Cervical, thoracic, and lumbar facet joint pain syndromes comprise 55%, 42%, and 31% of chronic spinal pain syndromes, respectively. Common facet joint disorders are degenerative disorders, such as osteoarthritis, hypertrophied superior articular process, and facet joint cysts; septic arthritis; systemic and metabolic disorders, such as ankylosing spondylitis or gout; and traumatic dislocations. The facet pain syndrome from osteoarthritis is suspected from a patient’s history (referred pain pattern) and physical examination (tenderness). Other facet joint disorders may cause radicular pain if mass effect from a facet joint cyst, hypertrophied superior articular process, or tumors compress the dorsal root ganglion. However, a high degree of morphological change does not always provoke pain. The superiority of innervating nerve block or direct joint injection for diagnosis and treatment is still a controversy. Treatment includes facet joint injection in facet joint osteoarthritis or whiplash injury provoking referred pain or decompression in mass effect in cases of hypertrophied superior articular process or facet joint cyst eliciting radicular pain. In addition, septic arthritis is treated using a proper antibiotic, based on infected tissue or blood culture. This review describes the diagnosis and treatment of common facet joint disorders.

Keywords: Arthritis, Infectious, Ganglia, Spinal, Hypertrophy, Intervertebral Disc, Osteoarthritis, Pain, Referred, Physical Examination, Synovial Cyst, Weight-Bearing, Zygapophyseal Joint