Spinal joint (facet) disease is a common cause for chronic back pain. It is felt by some to represent the most common source of chronic back pain. The mechanism contributing to pain is complex, involving the presence of reactions which induce and promote inflammation, facet nerve irritation and the presence of chemicals such as substance P which facilitates pain. These factors can be triggered by many stimuli including trauma, an inflammatory process, osteoarthritis, as well as distension, pinching and inflammation of the lining of the spine joints (synovial membrane). There are multiple treatment approaches available for individuals with facet disease. Successful conservative approaches include, anti-inflammatory approaches, spinal mobilization/manipulation, chiropractic care and local injections.