Pain in the neck: It might not be what you think

Feb 08, 2023
Don't let a pain in the neck be a pain in the neck
Facet joints, also known as zygapophysial joints, are small joints located along the spine that provide stability and support while also allowing for movement. Pain originating from these joints is commonly referred to as facet joint pain.

Facet Joint Pain: Neck and Low Back Referral Patterns

Neck Facet Joint Pain:

Facet joint pain in the neck can often present as a deep, aching pain in the neck, shoulder, or arm. It may also be accompanied by headaches, neck stiffness, and a decreased range of motion. This type of pain is often caused by arthritis, injury, or degenerative changes in the neck vertebrae.

Facet joint capsules are comprised of ligaments where mechanoreceptors are located.  Mechanoreceptors are sensory neurons that convert mechanical pressure into electrical signals that, in animals, are sent to the central nervous system.  A spinal manipulation (chiropractic spinal adjustment) stimulates the neurons in the capsule whereas exercise alone (physical therapy) does not. In addition, it has been shown that chiropractic spinal adjustments are safe to the joint capsule and ligaments that comprise the capsule.

Diagnosis and Treatment:

Diagnosis of facet joint pain is typically done through a physical exam, imaging tests (such as X-rays or MRIs), and/or nerve block injections. Treatment options may include chiropractic adjustment, exercises, stretching, and/or pain injections. 

While injections are an option they should be one of the last options because of the potential risks; spinal cord injury and peripheral nerve injuries, pneumothorax, air embolism, pain or swelling at the site of injection, chemical meningism, granulomatous inflammation of the synovium, aseptic acute arthritis, embolia cutis medicamentosa, skeletal muscle toxicity, and tendon and fascial ruptures.

In conclusion, facet joint pain can be a source of chronic neck and back pain. It is important to receive a proper diagnosis and treatment plan to manage and alleviate the symptoms associated with facet joint pain.


American Academy of Orthopaedic Surgeons. (2019, December 12). Facet Joint Arthritis. Retrieved from https://orthoinfo.aaos.org/en/diseases--conditions/facet-joint-arthritis/

Spine Health. (2021, June 17). Facet Joint Pain: Symptoms, Diagnosis, and Treatment. Retrieved from https://www.spine-health.com/conditions/lower-back-pain/facet-joint-pain-symptoms-diagnosis-and-treatment

Soal LJ, Bester CM, Shaw BS, Yelverton C. Changes in chronic neck pain following the introduction of a visco-elastic polyurethane foam pillow and/or chiropractic treatment. Health SA. 2019 Oct 9;24:1099. doi: 10.4102/hsag.v24i0.1099. PMID: 31934412; PMCID: PMC6917418.

Cheng J, Abdi S. COMPLICATIONS OF JOINT, TENDON, AND MUSCLE INJECTIONS. Tech Reg Anesth Pain Manag. 2007 Jul;11(3):141-147. doi: 10.1053/j.trap.2007.05.006. PMID: 18591992; PMCID: PMC2084363.