FACET ARTHROPATHY One of the common but, less often thought-about, causes of back and neck pain is facet joint arthropathy.  These joints are located on both sides of the spine and enable one vertebra to hinge upon the one above and below them.  These are true synovial joints similar to other joints in the body like the knees.  A number of different processes such as trauma and normal aging can make these joints painful.  Arthritis which is inflammation of the joints is not uncommon in these joints.  This could be as a result of normal aging process or trauma to the neck and back.  For example, whiplash injury to the neck after a car accident is a relatively common cause of head, neck, shoulder, and upper arm pain coming from these joints.  Sometimes, these joints can become hypertrophied (i.e. become bigger) and cause problems with spinal cord and nerve roots. Aside from a thorough evaluation and physical exam, the most reliable test is diagnostic medial branch block which is commonly known a facet block. For more information on this, please check the "Procedures" section on this website. Treatment is initiated with physical therapy in conjunction with anti-inflammatory agents. If the patients respond positively to diagnostic medial branch nerve block, radiofrequency lesioning of those nerves can potentially provide long term relief.