What it is
Facet joint osteoarthritis is characterised by wear and sensitisation of the small joints located at the back of the spine. It often presents with one-sided low back pain and stiffness after standing or bending. It can refer to the buttock or thigh without true nerve signs.
Care restores joint glide, improves hip and trunk mechanics, and builds endurance so standing, walking, and lifting feel smooth again.
What happens when it occurs
Capsules stiffen and muscles guard. Restoring motion with graded mobility, hip hinge work, and trunk endurance settles pain. Procedures are considered when flares persist.
Common causes and risk factors
- Age-related joint change
- Repetitive extension or rotation under load
- Deconditioning and previous back pain
Who is most affected
Adults in mid to later life. Manual and standing roles feature in Australian clinics.
Typical symptoms
- Local low back ache is worse with extension or standing
- Morning stiffness
- Buttock referral without nerve signs
When to seek care
If pain limits work, driving, or sleep, or if neurological signs appear.
How we diagnose
History, 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
- Medication or injections in selected cases
Rehabilitation milestones
Phase 1 week 0 to 2: pain control, gentle mobility, posture practice.
Phase 2 weeks 2 to 8: endurance and strength, hip hinge training.
Phase 3 months 2 to 6: task and sport at volume, self-management skills.
Readiness to progress
- Extension and standing without apprehension
- Endurance benchmarks met
- Workdays completed without the next day flare
Long-term care
- 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
- Only a minority need procedures
Latest insights
Restore glide, then protect it with endurance.
Hip mechanics reduce facet load during daily life.
