CONDITIONS • WESTMINSTER, ARVADA, BROOMFIELD, THORTON & DENVER METRO
Facet Joint Syndrome Treatment in Westminster, CO
Facet joint syndrome is one of the most common sources of neck and back pain in the world — and one of the most commonly missed, misattributed, and undertreated.
The stiffness and aching that is worst in the morning, the pain that makes bending backward feel impossible, the catching sensation with certain movements — this is often the facet joints, not the discs. Once that distinction is clearly understood, effective treatment becomes far more straightforward than most patients have been led to expect.
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WE UNDERSTAND WHAT YOU'RE GOING THROUGH
The stiffness when you first wake up. The pain when you lean back. The constant sense that your neck or back is just never fully free.
Facet joint pain has a specific character that is hard to describe unless you have experienced it. It is not the sharp shooting pain of a pinched nerve. It is more of a deep, gnawing ache — sometimes localized to a specific spot in the spine, sometimes spreading into the surrounding muscles and, in the neck, even into the back of the head or shoulder blades. It is worst first thing in the morning before the joint has warmed up. It is worse when you extend the spine backward or rotate to one side. It is often made briefly worse by movement but eases after a few minutes of activity. And it tends to build back through the day, so that by evening you are more guarded, more careful, and more aware of it than you were that morning. If this description fits your experience, you have almost certainly been walking around with unaddressed facet joint dysfunction for longer than you realize.
WHAT YOU MAY BE EXPERIENCING
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Stiffness and aching in the neck or back that is worst after rest and eases slightly with gentle movement
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Pain that worsens significantly when bending backward or rotating toward the painful side
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A localized, specific tenderness when pressing on one spot in the spine
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Referred aching into the shoulders, shoulder blades, or buttocks — without the sharp electric quality of nerve pain
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A gradual worsening through the day that builds with sustained postures like sitting or driving
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A sense of needing to stretch or crack the spine for temporary relief that returns within minutes
IF THIS SOUNDS FAMILIAR
You have probably been told you have muscle tension, arthritis, or degenerative disc disease. You may have been sent to physical therapy for core strengthening, told to take anti-inflammatories, or offered an injection. Some things helped briefly. The stiffness and aching returned.
What you almost certainly have not been told is that the facet joints are the primary source of a large proportion of all neck and back pain — and that they respond dramatically to specific, targeted treatment once they are correctly identified as the source.
WHAT YOU PROBABLY HAVEN'T BEEN TOLD
The facet joints — not the discs — are the most common source of neck and back pain. And they have a unique feature that makes them especially prone to becoming a chronic problem.
Most people who come in with neck or back pain have been told their problem is in the disc. The disc is what shows up most prominently on MRI. But research consistently shows that the facet joints — the small paired joints at the back of each vertebra that connect one spinal bone to the next — are the primary pain source in roughly 40 to 60 percent of chronic neck pain cases and a similarly large proportion of chronic low back pain cases. Understanding what a facet joint is, why it becomes painful, and why that pain can become self-sustaining is the key to understanding why this condition responds so well to the right treatment.
WHAT A FACET JOINT IS, WHY IT HURTS, AND WHY IT IS SO EASY TO MISS
Picture your spine as a stack of building blocks. At the front of each connection point sits the disc — the cushion most people have heard of. At the back of each connection point sit two small joints, one on each side, that allow the bones to glide on each other during movement. These are the facet joints. They are covered in cartilage, lined with a fluid-filled capsule, and loaded with nerve endings. When they become irritated, compressed, or restricted, they produce pain directly — and they also refer that pain to predictable regions of the neck, shoulder, mid-back, or buttock, depending on which level of the spine is affected.
Here is the part most patients never hear: facet joints are not well visualized on MRI. They are much better seen on CT scanning. An MRI that is "normal" or that shows only mild disc changes may be completely missing a painful, inflamed, or restricted facet joint sitting just millimeters away. This is one of the primary reasons so many patients are told their imaging does not explain their pain — when in reality, the right imaging of the right structure would have explained it very clearly.
The self-sustaining pain cycle
When a facet joint becomes irritated or restricted, the body responds by tightening the surrounding muscles to protect the joint. Those tightened muscles create additional compression on the already-irritated joint, which produces more pain, which causes more muscle tightening. This cycle can sustain facet joint pain completely independently of the original trigger. The joint never gets a chance to settle because the muscles are constantly compressing it. This is why facet joint syndrome so often feels like it is caused by the muscles — the muscles are significantly involved — but treating only the muscles without addressing the restricted joint underneath them produces relief that lasts only as long as the muscles stay relaxed.
Releasing the muscle while leaving the restricted joint untreated restarts the pain cycle within hours. The joint must be treated directly.
Referred pain from facet joints
Facet joints refer pain to predictable areas based on their spinal level — and that referred pain is routinely confused with other conditions. Cervical (neck) facet joints commonly refer pain to the back of the head, the shoulder blade, or the upper arm. Lumbar (lower back) facet joints commonly refer pain into the buttocks and upper thigh in a pattern easily confused with sciatica. This referred pain travels without the electric, shooting quality of nerve pain — it is more of a deep, diffuse aching. Knowing these referral patterns allows a skilled clinician to identify the specific joint responsible for your symptoms even without advanced imaging.
Many patients diagnosed with "tension headaches" or "glute tightness" are actually experiencing referred pain from cervical or lumbar facet joints that have never been assessed.
The loading problem that caused it
Facet joints become irritated and restricted when the spine is loaded unevenly and repeatedly over time. Forward head posture and thoracic rounding compress the facets in the neck and upper back. Sitting with a flattened lumbar curve removes the spine's natural shock absorption and compresses the facets in the lower back. Muscle imbalances — tight hip flexors, weak glutes, rounded shoulders — all change how load is distributed through the spine and accelerate facet joint stress. The loading problem is not only the source of the current pain; it is the reason the pain will return unless the loading is corrected alongside the joint treatment itself.
Adjusting a restricted facet joint without correcting the postural and muscular loading pattern that restricted it in the first place is a short-term solution to a longer-term problem.
Why facet joint syndrome responds so well to the right treatment
Facet joints respond very rapidly to chiropractic mobilization and manipulation. The restricted joint is freed, the muscle tightening reflex releases, and many patients notice immediate and significant reduction in their characteristic stiffness and aching within the first few sessions. This responsiveness is actually one of the diagnostic clues that the facet joint was the primary source — nothing responds to spinal adjustment the way a facet joint restriction does. The challenge is not short-term relief. It is making that relief last. And that requires correcting the loading pattern, strengthening the muscles that hold the spine in a healthy position, and addressing the systemic factors that keep the joint tissue inflamed.
UNDERSTANDING YOUR PAIN
Why facet joint syndrome feels different depending on where it is and how long it has been present
Which spinal level is affected, how long the joint has been restricted or irritated, and how the nervous system has responded to the chronic input all determine the specific pattern of symptoms and the most effective treatment approach.
Acute facet joint restriction
WHAT HAPPENING
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A sudden acute restriction of one or more facet joints — from an awkward movement, sleeping in a poor position, or a sudden increase in loading
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Intense protective muscle spasm holding the restricted joint in place
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Acute local inflammation within the joint capsule
WHAT IT FEELS LIKE
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Severe acute pain with dramatic limitation of movement in a specific direction
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A very localized point of tenderness in the spine
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The sense of being "locked" — that the spine cannot move freely in one direction without severe pain
Subacute and recurring facet syndrome
WHAT'S HAPPENING
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Recurrent restriction of the same joints because the loading pattern creating the restriction was never corrected
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The joint capsule has been repeatedly inflamed and is beginning to accumulate scar tissue
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The surrounding muscles have developed chronic trigger points from repeated protective guarding cycles
WHAT IT FEELS LIKE
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Flare-ups that follow a familiar pattern and come back every few weeks or months
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Each episode requiring less provocation than the last
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A low-level background stiffness and aching between acute episodes
Chronic facet syndrome with arthritic change
WHAT'S HAPPENING
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Years of uneven loading have produced arthritic changes — thinning of the cartilage, bone spur formation, and joint capsule thickening at the affected levels
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The nervous system has sensitized to the chronic input from the inflamed joints
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Systemic inflammation is amplifying the local joint reactivity and slowing recovery
WHAT IT FEELS LIKE
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Daily stiffness and aching that varies but is always present at some level
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Pain worsening with weather, stress, and systemic inflammation periods
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Treatment results that are significant but less dramatic or durable than in earlier stages
Why the stage determines the treatment
Acute facet restriction responds immediately and dramatically to direct joint mobilization — often providing more relief in a single session than months of other treatment. Subacute and recurring facet syndrome responds to joint treatment but requires correction of the loading pattern to hold between sessions and prevent the same restriction from returning. Chronic facet syndrome with arthritic change requires all of that plus nervous system regulation and systemic inflammation management, because the pain has become partly independent of the joint restriction itself and the body's healing environment needs to be optimized for the treatment to hold. Understanding which stage you are in is the starting point for building a plan that will actually work.
THE BIGGER PICTURE
What you've probably already tried
Most people with facet joint syndrome have tried several reasonable approaches and found that each one provided relief that faded within a day or a week. The problem is not that the treatments were wrong. It is that each one addressed one part of a multi-contributor cycle while the rest continued running.
TREATMENTS PEOPLE TYPICALLY TRY
✓ Anti-inflammatory medication and pain relief
✓ Massage therapy that helps temporarily
✓ General chiropractic care without addressing the loading pattern
✓ Facet joint injection or medial branch block
✓ Radiofrequency ablation to burn the nerves supplying the painful joint
✓ Core strengthening exercises that did not target the right muscles
Each of these addresses one aspect of facet syndrome. None of them correct the loading pattern creating the restriction, treat all three contributing systems simultaneously, or give the body what it needs internally to reduce joint inflammation and slow arthritic progression.
THE QUESTION THAT DESERVES A BETTER ANSWER
You have had an injection or two that provided weeks of relief and then faded. You have had massages that feel wonderful for a day and then the tension is back. You have done the exercises and they help while you do them but the stiffness is there the next morning regardless. The relief is real. The fact that it does not last is the problem — and it points directly to what has not been addressed.
"The injection worked for about six weeks and then the pain came back exactly as bad as before. Why doesn't anything last?"
Because the injection reduced the inflammation in the joint. But the forward head posture that was compressing the joint, the weak deep cervical flexors that were failing to share the load, and the tight pectoral muscles pulling the thoracic spine forward — all of those were still present the moment the injection wore off. The joint returned to the same mechanical environment that inflamed it in the first place. Correcting that environment is what makes relief last.
OUR FRAMEWORK
What's actually driving your facet joint syndrome
Facet joint syndrome is almost never caused by the joint restriction alone. The loading pattern that created the restriction, the nervous system's response to chronic joint irritation, and the biochemical environment that is either accelerating joint degeneration or supporting it all contribute to the full pain picture. Addressing all three simultaneously is what produces lasting outcomes.
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The Physical System
The restricted joint itself, the muscles caught in the protective spasm cycle, and the postural loading pattern that created the problem in the first place
What goes wrong
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One or more facet joints lose their normal gliding movement and become restricted — the joint surfaces are no longer moving freely against each other with every motion
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The joint's nerve endings fire a distress signal, triggering the surrounding muscles to tighten and compress the joint further — the self-sustaining pain cycle begins
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The posture that loaded the joint unevenly in the first place continues unchanged: forward head position, rounded thoracic spine, flattened lumbar curve, or any combination of these
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Adjacent joints compensate by moving more than they should, creating secondary restriction patterns at neighboring levels
Why that matters
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The muscle tightening that accompanies a restricted facet joint is not the cause — it is the consequence. Treating only the muscles produces relief that lasts only until the muscles respond to the restricted joint again, which is usually within hours to days
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The loading pattern that caused the restriction in the first place is the primary driver of recurrence. Until it is corrected, the same joint will be restricted again and again by the same forces acting on it every day
Mobilizing the restricted joint provides fast, dramatic relief. Correcting the loading pattern makes that relief permanent.
What this means
Assessment must identify the specific restricted joints, the referral pattern they are producing, the loading and postural contributors that caused them, and the muscle imbalances that are both a consequence of the restriction and a driver of its recurrence. Chiropractic care directly mobilizes the restricted joints with immediate effect. Dry needling releases the trigger points formed from chronic protective guarding. Physical therapy builds the strength and postural correction that keeps the joints in a mechanically favorable position throughout the day. All three together, applied consistently, produce lasting change.
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The Nervous System
Why facet joint pain can spread, intensify, and become chronic — and what can be done about it when it does
What goes wrong
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Facet joints have a rich nerve supply and are highly effective at generating referred pain — aching that is felt in a region away from the actual joint. Cervical facets commonly refer pain to the head, neck, and shoulder region. Lumbar facets commonly refer pain to the buttocks and upper thigh.
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When facet joint pain has been present for months or years, the spinal cord begins to amplify the signals from the affected joints. The pain region expands, the sensitivity increases, and stimuli that should not be painful start to trigger discomfort. This is central sensitization — and it is why chronic facet syndrome is more complex than acute facet restriction, even if the joint finding is similar on examination.
The stress response directly compresses the facet joints. People who carry tension in their neck and upper back often experience facet flare-ups during stressful periods for this reason.
What this feels like
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Pain that has spread from its original location to a broader region over time
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Treatment results that are less consistent than they used to be — the same adjustment or massage produces less relief than it did a year ago
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Flare-ups that are clearly linked to stress, poor sleep, or high-inflammation periods rather than just mechanical provocation
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Headaches or widespread upper back tension accompanying the localized facet pain
What this means
When sensitization is present alongside the structural facet restriction, the nervous system needs to be directly treated alongside the joint. Chiropractic care that consistently restores joint mobility sends calming signals into the spinal cord and progressively reduces the sensitization over time. Constitutional hydrotherapy and autonomic regulation directly address the stress component that is compressing the joints and amplifying the pain. And as the pain becomes less severe and more predictable, the fear-guarding cycle that is adding constant muscle compression to the already irritated joints can finally begin to break.
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The Biochemical System
The internal environment that is either inflaming the facet joints and accelerating their arthritic change — or supporting their ability to settle and maintain their cartilage
What Goes Wrong
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Systemic inflammation from gut dysbiosis, poor diet, or environmental toxins directly inflames the synovial lining of the facet joints — the same mechanism that drives rheumatoid and inflammatory arthritis elsewhere in the body, at a lower level
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Nutritional deficiencies in the building blocks of cartilage — collagen co-factors, omega-3 fatty acids, vitamin D — reduce the joint's ability to maintain its cartilage surfaces and repair normal wear
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Elevated cortisol from chronic stress suppresses the body's anti-inflammatory mechanisms and directly impairs connective tissue repair — a major reason facet syndrome is consistently worse during high-stress periods
What this feels like
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Facet pain that is clearly worse after dietary changes, illness, or high-stress periods
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Treatment that holds for progressively shorter periods despite appropriate structural care
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Other joint symptoms — in the hips, hands, or knees — appearing alongside the spinal facet pain, suggesting a systemic inflammatory component
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Arthritic changes on imaging that are progressing more quickly than age alone would explain
What this means
For patients whose facet syndrome has a clear systemic or inflammatory component — or whose treatment results are inconsistent despite appropriate structural care — naturopathic assessment of the internal environment is essential. Identifying and correcting systemic inflammation, nutritional deficits, cortisol dysregulation, and gut health creates an internal environment in which the structural treatment holds far more effectively. The joints settle faster, recover more completely between sessions, and are less reactive to the daily postural stresses that cannot be entirely eliminated from any modern person's life.
OUR APPROACH
How we treat facet joint syndrome differently
We directly mobilize the restricted joints for fast, significant relief. We address the loading pattern that caused the restriction so the same joint does not return to restriction within days. We treat the muscle trigger points caught in the protective spasm cycle. And for patients with chronic or inflammatory facet syndrome, we address the nervous system sensitization and internal biochemistry that standard care never touches. All at the same time.
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Mobilize the restricted joint, release the spasm cycle, and correct the loading
The joint, the muscles, and the loading pattern all need to be addressed in the same treatment plan — not sequentially.
Specific mobilization and manipulation of the restricted facet joints — restoring their normal gliding movement, immediately releasing the protective muscle spasm, and producing the rapid pain relief that is the hallmark of correctly treated facet syndrome
Release the chronic trigger points in the paraspinal muscles, upper trapezius, and levator scapulae that have formed from the recurrent protective guarding cycle and are themselves adding compressive load to the already-irritated joints
Reduce the chronic muscle tension that maintains compression on the facet joints between sessions and makes the relief from chiropractic care fade more quickly than it should
Correct the postural loading pattern — building the deep cervical flexors, mid-trapezius, and lumbar stabilizers that hold the spine in a mechanically favorable position and prevent the same joint restrictions from recurring
WHAT THIS CORRECTS
Joint restriction · Protective muscle spasm cycle · Postural loading pattern · Adjacent compensation levels
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Reduce nervous system sensitization and address the stress contribution
For chronic and stress-reactive facet syndrome, the nervous system needs direct regulation alongside the structural joint work.
Consistent joint mobilization progressively reduces central sensitization by sending calming mechanoreceptive signals through the spinal cord, breaking the cycle of chronic pain amplification
Mind-Body Counseling
Address the role of ongoing stress in driving the muscle compression and pain amplification that keeps facet syndrome active despite appropriate structural treatment
Constitutional Hydrotherapy
One of the most effective tools available for directly regulating the autonomic nervous system — reducing the chronic sympathetic activation that compresses the facet joints and amplifies the pain signal from them
Systemic parasympathetic activation that reduces the stress-driven muscle tension compressing the facet joints — producing a genuine nervous system shift that extends beyond the duration of the session
WHAT THIS CORRECTS
Central sensitization · Autonomic stress compression · Referred pain amplification · Treatment durability
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Optimize the internal environment for joint health and reduced inflammatory reactivity
Particularly important when treatment results fade quickly, or when systemic inflammation, stress hormones, or dietary factors are visibly driving flare-ups.
Identify and treat systemic inflammation, gut health, cortisol patterns, and nutritional deficiencies keeping the facet joint tissue inflamed and reactive independent of mechanical compression
Assess inflammatory markers, cortisol levels, vitamin D, collagen nutritional status, gut function, and any autoimmune markers that might explain unusually reactive or progressive facet joint disease
Reduce systemic inflammation, support deep muscle relaxation that extends to the paraspinal muscles, and improve the circulation to the facet joints that their cartilage maintenance depends on
Anti-inflammatory protocols, magnesium for muscle relaxation and nerve regulation, collagen co-factors for joint cartilage maintenance, and adrenal support for cortisol-driven facet reactivity
WHAT THIS CORRECTS
Systemic joint inflammation · Cortisol-driven reactivity · Cartilage nutritional support · Treatment durability
WHY THIS APPROACH WORKS
We treat the joint, the loading pattern, the nervous system, and the internal environment — all at once
Facet joint syndrome responds faster to correct treatment than almost any other spinal condition. The problem is that correct treatment is rarely delivered completely. Adjusting the joint without correcting the loading brings it back within days. Releasing the muscles without adjusting the joint leaves the trigger for the spasm intact. Doing both without addressing the nervous system sensitization or internal inflammation leaves the patient with diminishing returns over time. We deliver all of it — and that is why the results hold.
✓ The specific restricted joint and the spasm cycle it has created
✓ The loading and postural pattern that keeps recreating the restriction
✓ The internal biochemistry that is either inflaming or settling the joint between sessions
Facet joint syndrome is one of the most responsive conditions we treat. When the complete picture is addressed, results are often faster and more complete than patients who have been managing it for years ever expected.
WHO THIS IS FOR
This approach is for people whose neck or back pain...
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Is worst in the morning and when bending backward — the classic facet presentation
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Keeps coming back in the same place despite massage, stretching, or previous chiropractic care
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Has been attributed to "muscle tension" or "arthritis" without a specific treatment plan targeting the facet joints
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Clearly worsens with stress or systemic inflammation — suggesting the nervous system and biochemical systems are also involved
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Has been offered radiofrequency ablation or injections and wants to know whether a comprehensive conservative approach has truly been attempted before committing to procedures that destroy the nerves supplying the joint
TAKE THE NEXT STEP
Facet joint syndrome responds faster than almost anything else — when the complete picture is addressed.
We mobilize the joint, correct the loading, regulate the nervous system, and optimize the internal environment.
Not sure where to begin? Give us a call and we'll help you choose the best first step.