Apophyseal Joints (Facet Joints)

articulationes zygapophysiales

The facet joints (zygapophyseal joints) are paired synovial joints at each vertebral level that guide spinal motion, transmit shear loads, and protect the disc from excessive torsional stress. Their orientation varies by region — lumbar facets face sagittally to allow flexion-extension and resist rotation, thoracic facets face frontally to allow rotation, and cervical facets are oblique allowing multiplanar movement. Facet joint osteoarthritis is a major source of axial spinal pain and radicular symptoms from foraminal narrowing.

Region: Spine

Clinical Relevance

Clinical Notes

Facet joint pain (zygapophyseal joint pain) accounts for approximately 15 to 40 percent of chronic low back pain. The diagnosis is confirmed by at least 50 percent pain relief from dual medial branch nerve blocks that denervate the joint. Radiofrequency ablation of the medial branch nerves provides 6 to 12 months of effective pain relief in confirmed facet joint pain. Lumbar facet joint osteophytes encroach on the lateral recess and intervertebral foramen, contributing to lumbar spinal stenosis and radiculopathy.

Pathology

Common Injuries & Conditions

Facet Joint Syndrome

Zygapophyseal joint osteoarthritis or capsular sprain producing axial spinal pain reproduced by extension and rotation, confirmed by medial branch nerve blocks and managed with radiofrequency ablation.