What it is
Facet joint dysfunction is painful stiffness from the small joints at the back of the lumbar spine. It follows minor capsular strain or joint irritation and often presents after extension or rotation under load. Pain is usually one-sided and can refer to the buttocks or thigh.
Care restores joint glide, improves hip and trunk mechanics, and builds endurance so work and sport feel smooth again.
What happens when it occurs
Guarded paraspinal muscles compress the joint, limiting its glide. Capsules become sensitive. Restoring motion through graded mobility, hip hinge work, and trunk endurance helps settle pain and prevent recurrence.
Common causes and risk factors
- Prolonged standing or extension postures
- Repetitive bending and twisting under load
- Deconditioning and previous low back episodes
- Tight hip flexors and limited hip extension
Who is most affected
Adults in manual work or sports requiring rotation and impact. Office workers also present with long-standing or arched postures.
Typical symptoms
- Local low back ache is worse with extension or rotation
- Morning stiffness and pain after standing
- Buttock referral without nerve symptoms
When to seek care
If pain limits work, driving, or sleep for more than a few days, or if neurological signs appear.
How we diagnose
History and movement testing, palpation of segmental tenderness, and screening for nerve involvement. Imaging and injections are reserved for cases that persist.
Management
- Graded lumbar and thoracic mobility
- Hip mobility and hinge technique
- Trunk endurance and gluteal strength
- Manual therapy to assist with gliding, where appropriate
- Task and sleep position adjustments
Rehabilitation milestones
Phase 1 week 0 to 1: pain control, gentle mobility, posture practice.
Phase 2 weeks 1 to 4: endurance and strength, hip hinge training.
Phase 3 weeks 4 to 8: task and sport at volume, self-management skills.
Readiness to progress
- Extension and rotation without apprehension
- Endurance benchmarks met for trunk and hips
- Workdays completed without next-day flare
Prevention
- Maintain hip mobility and trunk endurance
- Balance pushing and pulling in training
- Progress loads steadily after breaks from activity
Australia snapshot
- Regular in primary care and physiotherapy
- Strong short-term outcomes with exercise
- Most do not require imaging or injections
Latest insights
Restore glide, then protect it with endurance.
Hip mechanics and trunk strength reduce facet load.
