Osteoarthritis (degenerative arthritis) can cause breakdown of cartilage between the facet joints. When the joints move, the lack of the cartilage causes pain as well as loss of motion and stiffness.

The facet joints are located in the back portion (posterior) of the spine. The joints combine with the disc space to create a three-joint complex at each vertebral level. The facet joint consists of two opposing bony surfaces with cartilage between them and a capsule around it that produces fluid

The combination of the cartilage and the fluid allows the joint to move with little friction. However, facet joint arthritis causes the cartilage to breakdown and the joint movement is associated with more friction. The patient loses motion and as they get stiffer they have more back pain.

See Facet Joint Disorders and Back Pain


Low Back Pain from Osteoarthritis

Typically, the low back pain is most pronounced first thing in the morning. Throughout the day, normal movement causes fluid to build up in the joint and it becomes better lubricated, which decreases the pain. Later in the day the pain typically becomes worse again as more stress is applied across the joint.

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Conservative Treatments for Osteoarthritis

Conservative (nonsurgical) treatments that concentrate on maintaining motion in the back are most effective for relieving the pain.

  • Stretching exercises for the hamstring muscles, hip joints, and the back can usually serve to prevent the pain from getting worse.
  • For more severe pain, chiropractic manipulations can help relieve pain.
  • Water therapy can be also be helpful since the joints are unweighted in the water and do not generate as much pain when being moved.
  • Acetaminophen is an effective and relatively safe non-prescription medication to help alleviate the pain, and some patients find NSAIDs (including COX-2 inhibitors) to be helpful.

Surgery for Osteoarthritis

The only effective surgical treatment option for osteoarthritis is a fusion to stop the motion at the painful joint, but this surgery is generally not recommended since multiple vertebral levels tend to be affected by osteoarthritis and multilevel fusions are generally not advisable.

For more in-depth information, see Facet Joint Osteoarthritis on Arthritis-health.com.

Dr. Peter Ullrich is an orthopedic surgeon who retired from practice with more than 20 years of experience specializing in spine surgery. Dr. Ullrich previously practiced as an orthopedic spine surgeon at the NeuroSpine Center of Wisconsin.