Facet Joint Disease


What is Facet Joint Disease?

Facet joint disease or facet joint syndrome is a form of osteoarthritis that attacks the facet joints along the back of your spine. For a few people, facet joint syndrome can be caused by a trauma to the facet joints such as an athletic injury or a car accident.

How common is facet joint disease?

In a recent study of 500 patients, who were complaining of back pain, it was found that painful cervical facets were identified in 55% of patients with neck pain, 42% of patients with thoracic pain, and 31% of patients with low back pain(1).

What is the function of facet joints?
Facet joints guide and constrain the motion of the vertebrae, while also enabling the transmission of the loads placed on the spine. Each level of your spine serves as a Three-Joint-Complex that includes a pair of facet joints, and an intervertebral disc. They provide flexibility and the stability to the spine(2). When your facet joints are weakened, your discs may be stressed and begin to rupture, vertebrae may start to slip, and your spine may lose some of its structural integrity as it slowly degenerates.
What are the symptoms of facet joint disease?
The type of pain you experience from facet joint disease is determined by the location of the injured facet joints along your spine. If the facet joints in the neck are inflamed, you may experience radiculopathy or radiating pain and numbness along your neck, between your shoulders, down your arms, and to your hands. If the facet joints in your lower or lumbar spine are stressed, the pain may radiate along your hips, thighs, legs and down to your feet.

Pain symptoms may increase after long periods of inactivity such as sitting at a desk too long or standing in line.

What are the treatments for facet joint disease?
Your facet joints may need rest to heal the inflammation that is causing the pain of facet joint syndrome. Taking it easy for a few days can work wonders by giving the tiny joints some rest. Dr. Nourian may suggest conservative physical therapy to improve your posture and modify the way you lift objects, turn or rise from a chair.

To relieve pain, Dr. Nourian will steer you away from opioid-based medications preferring safer, less addictive solutions such as non-steroidal anti-inflammatories, acupuncture, TENS electrical stimulation units, epidural treatments, and facet joint injections with nerve ablation.

He may suggest that you get your body moving with low resistance water therapy, walking and yoga. You may also find that with a few simple changes to your diet, you can lose weight and naturally fight inflammation.

The anatomical name for facet joints sounds funny, zygapophysial. However, there is nothing comical about the pain that often rises from these nerve-rich joints. Some patients may have pain that will not respond to non-surgical treatments. Dr. Nourian may suggest additional tests and carefully review the full range of surgical options including several minimally invasive microdecompression surgeries. All of Dr. Nourian’s surgical treatments are opioid-free during the operation and in recovery to prevent the risk of accidental drug addiction.

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Neck & Spine Specialities

Dr. Nourian has an enviable record of successfully treating the full spectrum of neck and spine problems.


Bulging/Herniated Discs

Disease & Disorders







Spinal Stenosis

Stiff Neck


General Orthopedics

Specialist in treating a wide variety of injuries and conditions that impact bones, joints, ligaments, tendons, muscles and nerves.



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What Patients Think About Dr. Nourian

Awesome awesome doctor!!!very nice to all his patient! Dr. Nourian is very kind and caring. A very pleasant man and easy to communicate with. He saw my son when he injured his hip and He took extra good care of him. After 2 wks he was able to resume sports. He’s not only a very good orthopedic surgeon but also an amazing Spine doctor. He always make sure he always gets the job done. 2 Thumbs up to this Doctor!!!??

Regz Ramos


Dr. Nourian was fantastic! He was able to alleviate my back pain. I would recommend him to anyone

Nikesh Patel


Dr. Nourian is the best. His bedside manner is friendly and professional and his staff is excellent. I went to see him after a terrible whiplash injury when I rear-ended while driving. After receiving my MRI results, the doctor was quick to reach out and went over my options with me. He really cares about his patients.

Michelle Sadighpour Shophet


Dr. Nourian is an outstanding physician. I injured my back while exercising recently. I went to see him, and he explained my injury to me in detail. He told me that my injury would most likely heal without surgery, but if I needed surgery in the future he would get me through it. He is honest, intelligent, and forthcoming. I am thankful for him as my spine physician.

Michael Broukhim


Dr. Nourian was absolutely fantastic. I was struggling with intense lower back pain. He took his time 40 minutes to be exact to see me and review everything with me after another follow up we decided to do surgery. Thank god!!! I’m back to working out, picking up my child, and living my best life. I was so hesitant to do surgery but he was a true god send. He would call me weekly to see how I’m doing.

Sara Sadig


Dr. Nourian is smart, caring, attentive and super knowledgeable. I highly recommend him as an orthopedic surgeon!

Sharon Darouvar Greiner


Great with patients and consciences of patient’s time as well as needs. He will spend time to assure the patients with respect to treatment plan and follow-up was amazing with my auntie’s back issues.

Connie Esparza


An extremely knowledgeable doctor with wonderful bedside manner. He clearly explained every step of the procedure and eased all my worries. My back is feeling great thanks to Doctor Nourian

Ashley Sadig


After seeing three doctors and all of them saying I should operate Dr Nourian was able to address and issue without and surgery. I got an epidural and did physical therapy and I’m able to run around with my grand child. He’s truly a gem. Everyone at the office was friendly and supportive.

Katrin Sadighpour


Dr. Nurian explained everything very well and preformed the surgery exactly as planned. I woke up pain free and the surgery pain was gone in five days. Could not give him enough praise.

Wade Savage