Back Pain from Intervertebral Disc and Facet Joint Conditions
Back pain is one of the most common health problems across all age groups — particularly among people who sit for long hours, older adults, and those whose work involves repetitive strain on the spine. Two structural problems that frequently occur together are dysfunction of the intervertebral disc and degeneration of the facet joints.
What Are the Intervertebral Disc and Facet Joints?
- The intervertebral disc sits between each pair of vertebrae, acting as a shock absorber and allowing the spine to move with flexibility. When a disc degenerates, tears, or herniates — bulging outward from its normal position — it can press on nearby nerves, producing back pain that may radiate down the hip or leg, sometimes with numbness.
- The facet joints are small paired joints located at the back of each vertebra. They control the direction of spinal movement and maintain overall spinal stability. When these joints become inflamed or degenerate, they produce localised back pain, stiffness, and restricted movement.
In many patients, disc degeneration and facet joint problems occur simultaneously. As the disc loses height and absorbs less load, the facet joints compensate by bearing more stress — accelerating their own wear and producing pain from two structures at once.
Common causes
- Age-related spinal degeneration
- Prolonged sitting or standing in poor posture
- Repetitive heavy lifting or twisting movements
- Injury or trauma to the back
- Herniated or degenerative intervertebral disc
- Facet joint osteoarthritis
Symptoms to Watch for
- A dull or deep ache in the lower or upper back
- Pain that worsens with bending forward, extending backward, twisting, or sitting for extended periods
- Radiating pain into the buttocks or down the leg (when a nerve is compressed)
- A feeling of stiffness or tightness that makes it difficult to move freely
- Back pain that is worst in the morning or after remaining in one position for too long
Treatment Options
Conservative Treatment
Initial treatment typically includes:
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Medication to reduce pain and inflammation
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Physiotherapy to restore mobility, correct movement patterns, and strengthen supporting muscles
For many patients, these approaches are sufficient to achieve meaningful improvement and recovery. However, if significant pain persists despite conservative care, interventional procedures may be considered.
Interventional pain procedures
- Facet joint steroid injection anti-inflammatory medication delivered directly into the affected joint to reduce swelling and pain
- Nerve block injection targeted anaesthetic to interrupt pain signal transmission from the affected spinal level
- Radiofrequency ablation (thermal neurotomy) uses heat generated by a radiofrequency probe to deactivate the small nerve branches transmitting pain from the facet joint
- Platelet-Rich Plasma (PRP) injection uses the patient's own blood-derived growth factors to promote tissue healing and reduce chronic inflammation
Prevention and Long-Term Care
- Maintain good posture while sitting, standing, and working
- Strengthen the back extensor muscles and abdominal core to provide better spinal support
- Avoid lifting heavy objects with poor technique — always bend at the knees, not the waist
- Maintain a healthy body weight to reduce mechanical load on the spine
- Exercise consistently — regular low-impact activity keeps the spinal muscles strong and the discs healthy
Back pain from intervertebral disc and facet joint problems is not something to simply push through or ignore. Understanding the true underlying cause and choosing appropriate treatment early makes a significant difference — reducing the risk of the pain becoming chronic and restoring a sustainable quality of life. problems is not something to ignore. Understanding the true cause of the pain — and choosing appropriate treatment early — significantly reduces the risk of developing chronic pain and helps restore long-term quality of life.
Reference
- Bogduk, N. (2016). Clinical anatomy of the lumbar spine and sacrum (5th ed.). Elsevier.
- Cohen, S. P., & Raja, S. N. (2007). Pathogenesis, diagnosis, and treatment of lumbar facet joint pain. Anaesthesiology, 106(3), 591–614. https://doi.org/10.1097/00000542-200703000-00024
- DePalma, M. J., & Ketchum, J. M. (2011). Etiology of chronic low back pain in patients having undergone lumbar fusion. Pain Medicine, 12(5), 732–739. https://doi.org/10.1111/j.1526-4637.2011.01102.x
- Manchikanti, L., et al. (2015). Lumbar facet joint interventions: Evidence-based practice guidelines. Pain Physician, 18(3), E535–E582.
- StatPearls. (2023). Lumbar degenerative disc disease. StatPearls Publishing.
https://www.ncbi.nlm.nih.gov/books/NBK448134/
Pain Management at Bangkok Interventional Clinic
At Bangkok Interventional Clinic, we focus on personalised, in-depth pain management tailored to each individual.
- All patients are evaluated and treated by a board-certified pain specialist, ensuring accuracy, safety, and effective care.
- Targeted interventional procedures for fast and effective symptom relief
- Patient education to support sustainable, long-term self-care
Our goal is to meaningfully improve the quality of life of every patient we treat. If you are living with pain that affects your daily life, the right diagnosis and the right treatment plan are where change begins.
