Back pain that’s worse when you stand up straight? It might not be a disc.
It may be the facet joints in your spine. Take the 1-minute quiz to see.
Could facet joints be causing your pain?
Answer 5 quick questions. It takes about a minute.
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This quiz is for general information only and is not a medical diagnosis. Only an in-person evaluation can determine the cause of your pain and the right treatment.
For many adults over 50, the source is the small facet joints in the spine. A simple, non-surgical test can show whether they’re causing your pain, and if they are, there’s an outpatient treatment that may help.
No surgery · No hospital stay · Medicare and most major insurance plans acceptedNot every back pain is a disc problem
Facet joints are small joints on the back of each vertebra that let your spine bend and twist. Like knees or hips, they can wear down with age and arthritis. When they’re irritated, the pain usually stays in the back or neck instead of shooting down a leg.
Because the pain doesn’t come from a pinched nerve, it often doesn’t improve with treatments aimed at discs, and many people are told to just live with it.
Signs your pain may come from the facet joints
- Aching in the low back or neck that has lasted 3 months or more
- Worse when you lean back, twist, or stand for a long time
- Stiff and sore getting up from a chair or out of bed
- Physical therapy, chiropractic care, or pain pills helped only for a while
The same arthritis that affects knees and hips, in your spine
Facet arthritis (also called facet joint osteoarthritis or facet arthropathy) is a common cause of long-lasting back and neck pain, especially in adults over 50. Each vertebra has a pair of facet joints at the back, lined with smooth cartilage and wrapped in a fluid-filled capsule. Over time, the cartilage thins, the joint lining becomes inflamed, and small bone spurs can form. The joint gets stiffer and more sensitive, especially when the spine bends backward or twists.
What causes it
- Normal wear and tear with age
- Disc wear, which shifts more of your weight onto the facet joints
- Past injuries, such as falls, car accidents, or sports injuries
- Years of lifting, bending, or standing at work
- Extra body weight and long-term posture habits
How it usually feels
- A deep, dull ache on one or both sides of the spine
- Stiffness in the morning or after sitting, easing as you move
- Pain when leaning back, twisting, or (in the neck) looking up or over your shoulder
- Low back: may spread to the buttock or upper thigh, but rarely below the knee
- Neck: may spread to the shoulders, upper back, or back of the head
Why it’s often missed
- Arthritis shows up on many X-rays and MRIs after 50, even in people without pain
- So a scan alone can’t prove the facets are the source of your pain
- A diagnostic block, which briefly numbs the nerves to those joints, is the most reliable way to confirm it
What helps
In early stages, physical therapy, core strengthening, staying active, weight management, and anti-inflammatory medicine (as your doctor advises) can keep symptoms in check. When those aren’t enough, a medial branch block can confirm the facets are the problem, and radiofrequency ablation may calm the pain so you can keep doing the things you enjoy.
How we find the source, and treat it
A clear, step-by-step process. Every step is outpatient, and you go home the same day.
Consultation
A full exam and a review of your history and any X-rays or MRIs, to see whether your pain pattern fits the facet joints.
Diagnostic test (medial branch block)
A small amount of numbing medicine is placed near the nerves to the facet joints under X-ray guidance. If your usual pain eases for a few hours, the facets are likely the source.
Treatment (radiofrequency ablation)
Gentle heat quiets those small pain nerves so they stop sending pain signals. For many patients, relief lasts many months, and it can be repeated if pain returns.
Meet your physicians
Dr. Samuel Rosenberg, DO
Physical Medicine & Rehabilitation
Dr. Rosenberg is a board-certified Physical Medicine & Rehabilitation physician. After residency at NYU Medical Center / Rusk Rehabilitation Institute, he served as an attending physician at Columbia University Medical Center as director of sub-acute rehabilitation services, then founded Spine & Rehabilitation Medicine Associates in Pomona in 2021. He focuses on non-operative treatments and works to avoid surgery.
Dr. Michael Chait, MD
Anesthesiology, Interventional Pain Management
Dr. Chait is a fellowship-trained interventional pain specialist. He focuses on minimally invasive, non-surgical treatments, including epidural steroid injections, nerve blocks, and radiofrequency ablation for chronic facet or sacroiliac joint pain. He earned his medical degree from the Technion Faculty of Medicine, completed his anesthesiology residency at Wayne State University and his Interventional Pain Medicine fellowship at Detroit Medical Center / Harper University Hospital, and is board certified by the American Board of Anesthesiology. He previously practiced in Michigan.
Medial branch blocks and radiofrequency ablation at our office are performed by Dr. Michael Chait, MD, who is board certified by the American Board of Anesthesiology and fellowship-trained in interventional pain medicine.
Common questions
Is this surgery?
No. Both the diagnostic block and radiofrequency ablation are done through a thin needle, with X-ray guidance, in an outpatient setting. There is no incision and no hospital stay.
Does it hurt?
Most patients feel pressure and brief discomfort. We numb the skin first, and most people return to light activity within a day or two.
How long does relief last?
It varies. For many patients, relief lasts many months, sometimes a year or longer, and the treatment can be repeated if the pain comes back.
Is it covered by insurance?
We accept Medicare and most major insurance carriers. Whether a procedure is covered depends on your plan’s medical criteria, such as pain lasting at least 3 months and trying other treatments first. Our team will check your benefits before scheduling.
Do I need a referral?
Many plans do not require one, but some do. Call us, and we will let you know what your plan needs. Bring any X-ray or MRI reports you have.
Find out what’s behind your back pain
Spine & Rehabilitation Medicine Associates · 26 Firemens Memorial Drive, Suite 120, Pomona, NY 10970 · Serving Rockland County: New City, Nanuet, Suffern, Spring Valley, Pearl River, and nearby.
Information on this page is educational and is not a substitute for medical advice. Results vary from person to person. Insurance coverage depends on your plan and medical history.
