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Out-of-state? Free MRI review + telehealth consult before you travel4.9 ★ · 619 Google reviewsBoard-certified — American Board of Orthopaedic SurgeryMinimally invasive, same-day spine surgery in Beverly HillsCall (424) 217-7463
Degenerative joint disease of the spine is osteoarthritis affecting the facet joints — the paired joints at the back of each spinal segment that guide and limit motion. Like the cartilage in a worn hip or knee, the smooth surfaces of these joints break down over time, and the body responds with inflammation and bone spurs. The result is a deep, aching pain that tends to sit close to the spine.
Because the facet joints are loaded when you stand upright and lean back, facet-driven pain typically worsens with extension — arching backward, standing for long periods, or walking downhill — and eases when you sit or bend forward. It is one of the most common sources of mechanical back and neck pain as people age, and it often coexists with disc wear and bone spurs.
Your spine is a complex and vital structure. Unfortunately, its complex structure makes it vulnerable to degenerative changes. Low back pain is one of the costliest and most common medical problems in the United States. Studies show that up to 80% of people experience at least one episode of low back pain in their lifetime. Degenerative joint disease, also known as spinal osteoarthritis, is one of the most common causes of low back pain.
Your spine is composed of repeated “units” consisting of a vertebra, a spongy intervertebral disc, and two facet joints, one on each side of the vertebra. The disc and facet joints of each vertebra are collectively known as the “3-joint complex.”
While facet joints are essential for your spinal flexibility, they are also prone to degenerative changes, known as degenerative joint disease (DJD) or spinal osteoarthritis. Typically, degenerative joint disease begins with thinning or degeneration of the articular cartilage within the facet joint. As the disease progresses, other parts of the facet joint can also be affected. DJD can occur on its own or together with degenerative disc disease. Most commonly, the two conditions occur together, but about 20% of people with degenerative joint disease don’t have degenerative disc changes.
Degenerative changes to the spine commonly occur with age, and not all abnormalities that show up on imaging tests will cause symptoms. However, if you’re experiencing back pain or other symptoms, it might be time to get specialized care.
✓Deep, aching back or neck pain close to the midline
✓Pain that worsens with arching backward or standing
✓Stiffness after rest that loosens with gentle movement
✓Pain referred into the buttock, hip, or shoulder region
✓Tenderness over the joints beside the spine
Degenerative joint disease can affect any level of the spine, but it is most common in the lumbar (lower) spine and the cervical spine (neck). Degenerative changes in the thoracic (middle) spine are less well-studied. Symptoms of degenerative joint disease can range from mild to severe, and may vary according to which part of your spine is affected. Other symptoms mayinclude:
Reduced range of motion in your back
Difficulty walking or incontinence (in severe cases)
Degenerative joint disease sometimes causes “referred pain,” which is when you feel pain in one part of your body, but the source of the pain is somewhere else. Lumbar DJD may cause referred pain in your hip, upper thigh, or flank (the side of your torso). Usually, pain from lumbar DJD doesn’t extend past your knee. Cervical DJD can cause referred pain in your shoulder, upper arm, or scapula, and may cause headaches affecting the back of your head.
Causes of Degenerative Joint Disease
Age-related breakdown of facet joint cartilage
Bone spurs forming as the joints wear (spondylosis)
Genetics: Susceptibility to DJD may be partially inherited
Obesity: Excess weight can increase the pressure and forces on your facet joints. Adipose (fat) tissue is also an important source of inflammation-promoting cytokines (chemical messengers). Having too much adipose tissue can cause low-level, chronic (long-term) inflammation that may contribute to DJD.
Gender: Women are more likely to experience spinal arthritis, especially after menopause.
Congenital spine abnormalities: Conditions like scoliosis can increase your risk of developing DJD.
Degenerative disc disease
How Is Degenerative Joint Disease Diagnosed?
Dr. Melamed pays attention to the pattern — pain that worsens with backward bending and standing and eases with forward flexion, along with tenderness over the joints. X-rays and MRI show the arthritic changes and rule out nerve compression. In some cases a diagnostic facet injection helps confirm that a specific joint is the pain generator before any treatment is chosen.
The Spine Pro offers diagnosis and treatment for degenerative joint disease in the heart of Beverly Hills, CA.
Several different conditions, including degenerative joint disease, degeneration of the intervertebral disc, and changes in spinal ligaments, can all contribute to narrowing of the spinal column and cause similar symptoms. Understanding the cause of your symptoms is an important step in choosing the right treatments.
Dr. Melamed may recommend X-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI), or a myelogram, a procedure that provides detailed images of your spine, spinal canal, and the nerves branching out from your spine. He’ll also ask you about your symptoms and lifestyle to understand how your DJD is impacting your life.
Degenerative Joint Disease Treatment Options in Beverly Hills
Facet-related degenerative joint disease is usually managed without surgery. The plan centers on physical therapy that builds core and postural support, activity adjustments to reduce joint loading, anti-inflammatory measures, and sometimes image-guided facet injections to calm an inflamed joint. For carefully selected patients, a radiofrequency procedure that quiets the small nerves supplying a painful joint can provide longer relief.
Surgery is not the usual answer for arthritis alone. It becomes a consideration only when the degenerative process also produces nerve compression — for instance, when bone spurs and a thickened joint crowd a nerve root or the canal. In that situation Dr. Melamed favors a muscle-sparing endoscopic decompression that relieves the nerve while preserving as much of the joint and muscle as possible, reserving fusion for the minority of cases with true instability.
At The Spine Pro in Beverly Hills, Dr. Melamed offers expert holistic care for the symptoms of degenerative joint disease. Dr. Melamed is a board-certified orthopedic spine surgeon. He specializes in holistic, noninvasive, individualized treatment for your spine problems.
If you are experiencing symptoms from DJD, Dr. Melamed will work with you to develop a treatment plan that fits your goals, lifestyle, and preferences. He favors holistic approaches like low-impact exercise, physical therapy, and alternative holistic strategies such as yoga, Pilates, tai chi, and acupuncture to strengthen your back and relieve pain. He may also recommend lifestyle changes such as diet management to control your weight and reduce inflammation, and quitting smoking if you are a smoker.
Dr. Melamed favors using alternative strategies for pain control, such as non-steroidal anti-inflammatory drugs (NSAIDs) and epidural corticosteroid injections.
At the Spine Pro, surgery is a last resort. If your symptoms don’t improve with conservative management, Dr. Melamed may recommend surgical intervention. He is an expert in minimally invasive treatment strategies and will carefully review your symptoms and imaging results before making any surgical recommendations. Common surgical strategies for treating DJD include microdecompressive techniques such as microlaminectomies and microlaminotomies. More severe DJD may require spinal fusion.
Unfortunately, DJD isn’t curable, and like any degenerative condition, your symptoms may change or worsen with age. However, appropriate treatment can help manage your symptoms and let you get back to the activities you enjoy. Dr. Melamed and his team at The Spine Pro will provide individualized and holistic support throughout your DJD journey.
Questions About Degenerative Joint Disease Treatment
Is degenerative joint disease the same as arthritis of the spine?
Degenerative joint disease of the spine specifically refers to osteoarthritis of the facet joints, which is one part of the broader picture of spinal arthritis. Spinal arthritis is the umbrella term and can also involve the discs and other structures. In practice the two overlap, and imaging clarifies which structures are driving your pain.
Do I need surgery for facet arthritis?
Most facet-driven pain is managed without surgery, using therapy, activity changes, injections, and sometimes a radiofrequency procedure to quiet the joint's nerves. Surgery is considered only when the arthritis also compresses a nerve, and even then Dr. Melamed favors a muscle-sparing decompression over fusion whenever the segment is stable.
Why does my back hurt more when I lean back?
The facet joints carry more load when you extend or arch the spine, so leaning back, standing for long periods, or walking downhill tends to aggravate arthritic joints, while sitting or bending forward often relieves them. That pattern is a useful clue that the facets are involved.
Can the arthritis be reversed?
The cartilage changes themselves are not reversible, but the pain they cause is very manageable. The goal is to control inflammation, strengthen the muscles that support the spine, and reduce joint loading so you can stay active. Many people keep facet arthritis comfortable for years without an operation.
