Spinal arthritis causes stiffness and low back pain. The stiffness is worst upon waking up in the morning, tends to ease with activity, then worsens toward the end of the day. Presumably, this is because fluid has built up in the joint due to inactivity overnight, which causes more swelling.

The low back pain due to facet joint arthritis has a typical pattern:

  • The pain is mostly — more than 80% — in the back, runs into the buttocks, and often really feels like it’s in the hip.
  • As it gets even worse people often report burning on the outer aspect of the thigh, and sometimes pain down the leg.

    See Leg Pain and Numbness: What Might These Symptoms Mean?

  • Because the pain runs down the leg people, even doctors sometimes, confuse it with nerve root pain.

    See Accurately Diagnosing Leg Pain

Typical Symptoms of Spinal Osteoarthritis

The full range of symptoms that typically occur with spinal arthritis includes some combination of the following:

  • The back and/or neck stiffness and pain tend to be worse in the morning (particularly for about 30 minutes after waking up), often called "first movement pain."
  • The pain will usually subside to a more tolerable level over the course of the day as the person carries on his or her activities.
  • Pain and stiffness tend to get worse again in the evening.
  • Pain that disrupts sleep is often an indicator of osteoarthritis.
  • Swelling and warmth in one or more joints, particularly during weather changes (which may be related to barometric pressure changes and cooling of the air).
  • Localized tenderness when the joint or affected area of the spine is pressed.
  • Steady or intermittent pain in a joint, which is often described as an aching type of pain. The pain may be aggravated by motion.
  • Loss of flexibility of a joint, such as inability to bend and pick something off the floor.
  • A crunching feeling or sound of bone rubbing on bone when the joint is moved (called crepitus), particularly notable in the neck.

    See Neck Cracking and Grinding: What Does It Mean?

  • A sensation of pinching, tingling, or numbness in a nerve or the spinal cord, which can occur when bone spurs form at the edge of the joints of the spine and irritate the nerves.
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Facet joint pain and stiffness can begin to occur after long periods of inactivity, such as while sitting for long journeys or watching a two-hour movie. With advanced osteoarthritis and increased rasping friction between bones, the pain often becomes substantial even at rest or with very little movement.

See Treatment Options for Facet Joint Disorders

With progressive osteoarthritis, a single joint may at first be affected, but with time and further activities, many joints of the body may be affected – in the base of the neck, or in the knees, hips, hands, and/or feet.

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Although less common, some patients may experience severe deformities of certain joints over time. Osteoarthritis differs from rheumatoid arthritis and other systemic forms of arthritis because it only affects joints (although it may lead to an entrapment of a nerve at any level in the spine or the spinal cord in the neck) and does not affect organs or soft tissue areas of the body.

Dr. Daniel Lieberman is a neurosurgeon and founder of Phoenix Spine & Joint. He specializes in spine surgery and has more than 15 years of clinical experience. In addition to providing spine care, Dr. Lieberman has served as Adjunct Faculty at the Biodesign Institute of Arizona State University.

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