Facet joint disease/dysfunction is a common source of cervical (neck) pain. The facet joints (also termed zygapophyseal joints) form from the superior and inferior articular processes of two adjacent vertebrae. In each spinal motion segment, there are two facet joints. Each facet joint is surrounded by a fibrous capsule, lined by a synovial membrane, and contains articular cartilage and menisci. Various studies suggest facet joint capsules may directly be involved as a pain generator in the cervical spine.

The prevalence of this disease increases with age and is a common source of disability and dysfunction in patients. The most common cause of facet joint disease is degeneration of the spine, also known as spondylosis. The term osteoarthritis (OA) refers to degeneration of the joint (cartilage)  secondary to natural wearing and abnormal body mechanics. Other causes of cervical joint disease include trauma (motor vehicle accidents, fractures, dislocation, high impact sporting activities), inflammatory conditions (rheumatoid arthritis, ankylosing spondylitis) and spondylolisthesis (subluxation of the facet joint).

Most common symptoms of cervical joint dysfunction include neck pain, limited and painful extension and rotation of the neck, tenderness on palpation, radiating pain into the shoulder or upper back. The clinical presentation of this condition is similar to axial neck pain of other aetiologies including spinal stenosis, cervical strain, and discogenic pain. To diagnose this condition, your health care professional will assess your posture, range of motion/motion palpation, neurological examination, palpation, orthopaedic testing and diagnostic imaging if indicated. Conservative treatment/management is used as first-line therapy for this condition.

The majority of patients respond well to cervical manipulation (SMT), mobilizations of the joint, active release therapy, exercise, and NSAID’s. Education is also a key component of the treatment plan. This includes explaining the diagnoses or impairment to the patient to help reduce their anxiety. When conservative measures fail, interventional procedures are considered to reduce the pain and improve function.