The thoracic facet joints face nearly coronally (frontal plane), enabling the thoracic spine's primary motion of rotation while limiting the sagittal flexion-extension that the lumbar spine performs. This orientation explains why the thoracic spine is most mobile in rotation and why thoracic rotation deficits force compensatory motion at adjacent segments. Already somewhat covered as facet-joints — this entry provides thoracic-specific detail.
Thoracic facet syndrome produces paraspinal pain at the affected level with referred pain anteriorly around the chest wall that mimics cardiac or pleuropulmonary pain. Medial branch blocks at two levels denervating each joint are required for diagnosis and radiofrequency ablation for sustained relief.
Thoracic zygapophyseal joint degeneration producing paraspinal pain with anterior chest referral managed with medial branch blocks and radiofrequency ablation.
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