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Dr. Joshua C. Huffman palpating a prone patient's lower back during a facet syndrome examination.

For people in San Antonio whose back is fine in a chair and furious at the kitchen counter

The back pain that hates standinghas a name.

See if you're a candidate Decode your back's rules

If your back aches when you stand at the counter, arch to reach a high shelf, or spend an hour on your feet — and quiets down the moment you sit — the likely culprit is your facet joints. They're the small paired joints at the back of every level of your spine, and they wear the way knees wear. Usually they wear for a reason: the disc in front of them lost height first, and they've been carrying weight they were never built to carry. That's the part we treat — with a non-surgical program built around the FDA-cleared DRX9000, plus the strengthening that keeps the load off. Injections are performed here too, by our interventional pain-management physician — so when we recommend the mechanical program instead, it isn't because it's all we offer. The exam decides what your case actually needs.

23 years in practice
21 years using the DRX9000
2,000+ patients treated on it

You've noticed your back has rules.

Standing at the sink to do a sink full of dishes: bad. Ten minutes at the stove: fine. Twenty-five: not fine. Walking slowly through a store is somehow worse than walking briskly around the block. Standing in a line — at the pharmacy, at church, at the airport — is the worst thing you do all week, and you've started scanning rooms for something to lean on.

Reaching up to the top shelf brings a jolt across your low back. Sometimes it settles into a deep ache high in the buttock, or down the back of the thigh — but it stops above the knee. It doesn't run to your foot.

And then the strange part, the part that confuses everyone you've told: sitting helps. Leaning on the shopping cart helps. Leaning your elbows on the counter helps. You can drive an hour with no trouble, then get out of the car and hurt. Mornings are stiff for twenty minutes, then loosen — and the ache comes back in the afternoon, after you've been upright all day.

Somewhere along the way, a report used the words "facet arthropathy" or "facet hypertrophy." Or a doctor said "you've got a little arthritis in your spine" — in the tone people use for gray hair. Maybe you got a shot that worked, and worked well, for six good weeks. And then the ache moved back in and you were told to come back for another one.

Those rules your back follows are not random. They're the signature of a specific joint, under a specific kind of load. Reading them correctly is the difference between getting this treated and getting it managed.

Start here

Meet your facet joints

Everyone knows about the discs. Almost nobody gets told about the joints.

At the back of your spine, every level has a pair of small joints — one on the left, one on the right. They're called facet joints. Think of them as little knuckles, stacked in two columns down your back, linking each bone in your spine to the one above and the one below.

They are real joints, in every sense that matters:

  • Cartilage on both surfaces — the same smooth, slick material that covers the ends of the bones in your knee
  • A capsule around the joint, sealed and filled with lubricating fluid
  • A rich supply of nerve endings — each joint has its own small nerve branch whose entire job is reporting on that joint

That last one is why they hurt so specifically. A facet joint is wired to complain, and when one is irritated it has a direct line to you.

Their job is twofold. They steer, and they share. They act as guide rails, deciding how much each level of your spine can bend, twist and lean back. And they share the load with the disc in front of them — the disc is the shock absorber, the joints behind it are guides that also carry weight.

How much weight depends entirely on how you're standing. That's the whole story of this page.

Illustration of the lumbar spine from the side: the vertebral bodies and discs in front, the paired facet joints behind, with an inset showing a single facet joint's capsule and fluid-filled cavity.
The discs sit in front, the paired facet joints behind. The inset is one joint up close: cartilage surfaces, a sealed capsule and the fluid inside it.

The clue in your own symptoms

Your back's rules, decoded

Here's the mechanism, and it's simple enough to feel while you read it.

When you stand tall or arch backward, the facet joints close and press together — and their share of the load climbs. When you sit or lean forward, they open up and rest.

Now run your own rules through that:

Standing at the sink hurts; leaning your elbows on the counter helps.

Leaning forward opens the joints. It's the cheapest treatment you've ever found, and you found it yourself.

Reaching for the top shelf hurts.

Reaching up arches your low back. So does hanging laundry, painting a ceiling, and blow-drying your hair.

Walking slowly is worse than walking briskly.

Strolling means minute after minute standing upright. A brisk walk brings a slight forward lean and a rhythm that keeps you out of the arched position.

Downhill is worse than uphill.

Uphill tips you forward. Going down, you lean back to brake — the exact position these joints hate.

Standing still is worse than moving.

A line, a party, a museum. No motion, no relief.

Getting out of a chair is the sharp moment.

You're re-entering the loaded position, and the first few steps are the price.

Lying flat on your back is worse than lying with a pillow under your knees.

Flat leaves your low back arched; the pillow flattens it out.

Sitting, driving and biking are fine or better.

Every one of them leans you slightly forward.

If most of that list is your life, you've already run the experiment a hundred times without knowing what you were testing.

And here's the contrast that makes it useful. The classic disc patient is your mirror image. They can't sit. Long drives wreck them. They stand up at restaurants and pace at the back of church, because bending forward is what hurts them and standing is their relief. Same spine, same neighborhood — opposite rules.

What position are you in when it's at its worst?

That's one of the most useful questions in a spine exam, and also one of the simplest. Your answer tells us where to look before we ever touch you.

The pain map

Where facet pain travels — and where it stops

Facet pain isn't always polite enough to stay where the joint is.

Typically it sits deep and one-sided, right around your belt line, and spreads into the buttock, sometimes into the back or side of the thigh. It's an ache, a pressure, a toothache in a joint you can't reach. It builds through the day, and it can flare for two or three days after a Saturday of yard work and then settle.

Yeoman's test being performed on a patient lying face down during a spinal examination.
Provocation testing — we reproduce the pain on purpose, because which movement brings it on tells us which structure is generating it.

And here's the part worth writing down: it usually stops above the knee.

True nerve pain — the kind a pinched nerve root produces — behaves differently. Patients call it electric, burning, lightning. "My whole leg lights up." It runs in a stripe past the knee, into the calf, into the foot, into specific toes, often with numbness or real weakness.

Why does a joint in your back make your buttock hurt at all? Because the joint and the skin and muscle of your buttock report to the same neighborhood of your spinal cord. The signals arrive on shared wiring, and your brain makes its best guess about where they came from. Sometimes it guesses wrong, in a predictable way. The joint isn't touching the nerve that runs to your leg — it's borrowing the same phone line.

Two straight cautions on that map:

  1. Plenty of people have both. A worn disc that's crowding a nerve and the overloaded joints behind it. The pattern tells us which one is doing most of the talking, not that only one exists.
  2. A pattern is a clue, not a diagnosis. Hips, sacroiliac joints and deep hip muscles all refer into the same territory. That's what an exam is for.

If your neck is the problem instead, the same joints exist up there and behave the same way. Neck facets refer pain into the base of the skull, the shoulder blade, and the top of the shoulder — and checking your blind spot or backing out of a driveway becomes the movement you dread. Same rules: extension and rotation load them. Neck pain.

Warning signs that skip the line entirely:

New loss of bladder or bowel control, numbness in the groin, the inner thighs, or the area you sit on — what doctors call saddle anesthesia — or rapidly worsening weakness. That's an emergency room today, not an appointment.

The cascade

Why the joint wore out in the first place

Facet joints rarely wear out for no reason. Most of the time, they lost a fight that started in front of them.

Picture one level of your spine as a three-legged stool: the disc in front, and the two facet joints behind. Those three parts share every pound you put through that level. They rise and fall together.

Now take one leg down. The disc dries out and loses height — years of accumulated load, and the reason a spine at 55 doesn't measure the same as a spine at 25. As that disc flattens, the bones above and below settle closer together. The facet joints are attached to those bones, so they settle too. They telescope in on each other, and the cartilage surfaces press harder over a smaller area.

That's the cascade. Cartilage built to guide motion is suddenly carrying weight. It wears. The joint inflames. The capsule thickens. The body adds bone at the edges trying to spread the load — the "spurring" or "hypertrophy" on your report. The muscles around the segment tighten to guard it, which costs you motion, which puts more work on the levels above and below. Round and round.

On a radiologist's screen, that's "facet arthropathy." In your kitchen, it's the ache at the counter.

Dr. Kevin Barton using a spine model to show a patient how the disc in front and the two facet joints behind it share the load at each level.
The three-legged stool. The disc in front, the two facet joints behind — three parts sharing every pound. When the disc loses height, the joints behind it inherit the weight.

Two things follow from that, and they're the reasons this page exists:

First: treating only the joint disappoints. You can calm an angry joint down — and calming it down is genuinely useful. But if the reason it's angry is that the disc in front of it collapsed and handed it a job it can't do, then quieting the joint leaves the load exactly where it was. When the quiet wears off, the mechanics are unchanged and waiting.

Second: an enlarged facet joint takes up room. The nerves leaving your spine pass right by these joints. When a joint thickens with arthritis, it can crowd that exit. That's one of the ways facet arthritis quietly turns into spinal stenosis — and why some people have the standing-hurts facet pattern and legs that get heavy after a block. Degenerative disc disease is where the cascade usually starts.

The verdict, revisited

"You've got some arthritis in your spine"

Somebody said this to you, and it landed like a verdict.

Here's the context nobody gave you with it. Wear in these joints is close to universal on imaging past 50. Radiologists report it because it's there and reporting it is their job. But plenty of people carry those exact words on a report with no pain at all — and plenty of people hurt badly with reports that read mild.

So the report tells us the terrain. It doesn't tell us what's talking.

We treat your exam, not your report. We put your spine through the positions that load and unload those joints and watch what happens. We test the hips and the sacroiliac joints, because both refer into the same neighborhood. We check whether a nerve is actually involved. Then we go through your imaging with you, on a screen, and see whether the story on the film matches the story in your body.

Sometimes it doesn't. When it doesn't, we say so.

And that "on a screen, with you" part is not a small detail. Patients tell us the same thing all the time: nobody ever showed them the pictures. There's a reason. The doctor most trained to read your MRI — the radiologist — writes the report and never meets you. The doctors who do meet you usually work from that report, and a surgeon's schedule rarely has room to sit down and walk through the images with you. Nobody did anything wrong — and you still ended up owning a spine you've never seen.

We think that's backwards. Your consultation happens in front of a screen with your MRI on it. We go through the pictures — not just the report — and show you what's pressing on what, why it hurts the way it does, and exactly what we plan to do about it. You leave understanding what your spine looks like and how we intend to fix it.

Kevin S. Barton, D.C., bending a patient's knee toward the chest during an exam to load the joints at the back of the spine.
The exam comes first. Positional tests load the joints at the back of your spine to see which one answers.
Front and side X-ray views of a lumbar spine and pelvis.
Films show wear, not pain. X-rays tell us how the levels are stacked and how much height the discs have lost.
Joshua C. Huffman, D.C., pointing at a patient's MRI on the screen while she watches.
Then we go through it with you. On the screen, level by level — what's worn, what's loaded, and what that means for the plan.

The mechanism

How our program works

The first line is hands-on, and it works. A facet joint that hurts is usually a facet joint that has stopped moving well. Spinal manipulation — the adjustment — restores that motion, and the muscles guarding the segment let go with it. For a lot of facet patients that is the treatment: a course of adjustments, some soft-tissue work, and the pain settles.

The stubborn cases have something else going on underneath. When the adjustment helps but won't hold — the pain keeps coming back to the same level — it is almost always because the disc in front of that joint has lost height, and the joints behind it are carrying weight they were never built to carry. That is degenerative disc disease and facet syndrome together, which is how facet syndrome usually shows up. Adjusting a joint that's being crushed from the front can only do so much. That's when we recommend decompression — and the adjustments keep going alongside it.

Our lane is the load.

Remember the cascade: the disc in front lost height, and the joints behind it started carrying weight they weren't built for. Change that, and you're treating the cause instead of the complaint.

At the center of the program is the DRX9000 — an FDA-cleared, computer-controlled spinal decompression system. You lie on a table for about 25 to 30 minutes while it applies a precise, gentle, rhythmic pull to the exact level we're treating. Inside the disc, that pull creates negative pressure — a vacuum effect that's been measured directly inside human discs.1 Fluid and nutrients draw back in. The disc rehydrates and can regain some height.

And when the disc in front gets height back, the joints behind it get room. They stop telescoping into each other. Joints that have been locked down under compression start moving again, and when they move, the muscles that have been guarding them let go. That's four tissues at once — muscles, facet joints, nerves, and disc — which is the whole argument for this machine and the reason Dr. Barton built his program around it. The four tissues — how the DRX9000 works.

Joshua C. Huffman, D.C., performing a spinal adjustment on a patient lying on the treatment table.
The adjustment. When a facet joint has stopped moving well, this is where treatment starts — and it continues through the decompression program.
A Texas Spine Clinic team member fitting the DRX9000 pelvic harness around a patient's hips before treatment.
Getting set up. Fully clothed — the pelvic harness goes on over your own clothes before you lie down.
A patient lying on the DRX9000 table while a team member sets the console and Dr. Huffman reviews her chart.
On the table. About 25–30 minutes. The pull is aimed at the one level being treated, on a force curve set by hand and adjusted as you respond.

Running alongside it is the strength work, and it is not optional. As the pain settles, we rebuild what Dr. Barton calls your structural margin:

  • Hip flexibility. Tight hip flexors tip your pelvis forward and hold your low back in the arched position — the position your facets hate. Loosen those, and you spend your whole day in less extension without thinking about it.
  • Deep core and glute strength, so standing tall doesn't mean standing arched.
  • Movement habits. How to reach a high shelf, how to stand at a counter, how to get out of a chair — small changes that take real load off the joints all day long.

The strength work is what makes decompression hold. A program that stops the day your last decompression session ends is a program that sends you back to the same mechanics that wore the joint out.

For a lot of facet patients, that's the whole answer — because nothing they'd tried before had ever changed the load on the joint.

"Isn't this just traction?"

It's in the traction family, and we'll say so plainly. What's different is control. Old traction pulled in a straight line with a weight and a rope, and the body's natural reflex was to tense against it — which defeats the purpose. This system ramps force along a computer-controlled curve designed to slip under that guarding reflex, at a pull angle set for the specific level being treated, and adjusts as your spine responds week to week. That's the difference between a table and a treatment — and it's why who runs the machine matters as much as the machine.

"Won't pulling on an arthritic joint make it worse?"

Fair question, and the straight answer is in the direction of the force. Decompression unloads the segment — it takes pressure off, it doesn't push you into the arched position that provokes you. That said: some patients feel stirred up in the first week or two. We'd rather tell you that now than explain it after. If a protocol is aggravating you, the angle and the force get changed, or we stop. We don't just keep pulling.

"How do I know it will be done right?"

Ask us the hard questions — we like them. Here's how care is decided here, and you can hold us to every line:

  • A doctor reviews your actual MRI before anyone discusses a plan or a price
  • A disc is never diagnosed from an X-ray — only an MRI or CT can show one
  • Your plan is built for your spine and adjusted as you respond — never a one-size program
  • Your cost is in writing before your program begins

Evaluation first, always. We examine you and review your actual imaging before anyone discusses a plan or a number.

"Why does it take so many visits?"

Because cartilage, discs and muscle don't change on a schedule that suits anybody. The disc is avascular, meaning it has no blood vessels of its own, which is why it's one of the slowest-healing structures in your body. Most programs run about 20 to 25 sessions over 6 to 8 weeks, several visits a week, and core strengthening runs alongside and past it. That's a real commitment and we won't dress it up. It's also why we build in a real checkpoint rather than asking you to hope for two months — see below.

The two reasons this program works

The first is the machine — and knowing how to run it. The DRX9000 is genuinely effective at what it does, but owning one and knowing how to use it are different things. Every protocol is set by hand: the angle of pull, the force curve, the specific level being treated, adjusted as your spine responds week to week. We've been doing that for 21 years. That experience is the difference between a table and a treatment.

The second matters just as much, and almost nobody in this industry will tell you about it:

We screen patients the way a spine surgeon screens surgical candidates.

Weigh it against the alternative

The case for trying this first

Whatever else you decide about this program, weigh what it asks of you. No incision. No anesthesia. No hardware in your spine. No fusion. No narcotics and nothing to wean off. No recovery period, and no time off work — sessions run about half an hour and you drive yourself home afterward.

And nothing about it closes a door. Whatever options you have today — an injection, a surgical consult, a second opinion — you'll still have every one of them when you're done here. That isn't true in the other direction. A fused segment doesn't come back, and scar tissue doesn't unform. Trying the reversible thing first isn't a compromise; it's the order that makes sense.

Why this works

Why this works — and who we won't treat

We perform injections here too — and we still won't sell you one you don't need.

Interventional pain management, physician-performed, is part of this practice. That matters for exactly one reason: when we recommend the mechanical program instead, it isn't because it's all we have. Both lanes — mechanical and interventional — are under this roof, and the exam decides which one your case actually needs.

So here's the straight version of the map. Some facet joints are inflamed enough that they need to be calmed directly before mechanical work can get any traction. Some cases genuinely need a diagnostic block to prove which joint is guilty before anyone treats anything. If your exam points there, we'll say so — and the physician who does that work is down the hall, not across town.

Worn cartilage does not grow back.

We won't tell you otherwise, and anybody who does is selling something. What can change is the load on the joint and the noise coming from it — which is the difference between arthritis on a report and arthritis that runs your day. Knees make this easy to understand: two people with identical X-rays, one hiking and one housebound, and the difference is mechanics and strength, not cartilage.

The first week or two can stir things up.

Some patients get sore, or feel a temporary echo of their usual ache, before things turn. That's common enough that we're telling you before you start.

Our program addresses one driver of facet pain well — not all of them.

Facet pain has several possible drivers, and our program addresses one of them well. If yours isn't that one, hearing it costs you a single visit instead of a course of treatment.

Some pain that looks like facet pain isn't mechanical at all. If you're younger, stiff for more than an hour every morning, better with exercise than rest, waking in the night with pain, or hurting in other joints too, that pattern can point to inflammatory arthritis. That's a question for a rheumatologist and a blood test, not a decompression table — and we'd rather send you there than treat you for a year.

Candidacy

Who we will not treat

Decompression is the wrong tool — and we'll say so — if you have:

  • Spinal fusion or hardware at the level we'd be treating — no exceptions
  • Severe osteoporosis; spinal fracture, tumour or infection
  • Severe bony stenosis — no table un-grows bone; that's a surgeon's conversation
  • Unstable spondylolisthesis — a slip that shifts more than 5 mm on the flexion-and-extension X-rays we take to check. A stable slip, of any grade, can still be a candidate.
  • Pregnancy
  • Cauda equina warning signs — new bladder or bowel changes, groin numbness, rapidly worsening weakness. That's an emergency room today, not an appointment.
We have turned away more patients than we can count — including people who pushed, pleaded and offered to pay in full. Saying no costs us money every time. It's also the only reason we've been able to do this for 21 years and still have the reputation we have.

The exam and your imaging — not the machine, and not your credit card — decide whether someone is treated here.

The real checkpoint

We assess whether your spine is responding around the second week, after eight to ten sessions. If it isn't, we say so then — not after another month of visits — and you don't pay for the rest.

Dr. Kevin Barton positioning a patient at the X-ray unit for flexion and extension views of the lower back.
The stability check. Flexion-and-extension X-rays show whether a slipped vertebra moves — the step that decides whether a spondylolisthesis is stable enough to treat.

What it costs

What insurance covers, and what to expect

You'll have your figure in writing before you commit to anything.

The decompression program isn't a covered benefit under any plan. If you carry a commercial health plan, we can usually generate an insurance credit through it, which we apply against your cost. How big that credit is depends on your specific benefits. So expect an out-of-pocket investment, and expect to know exactly what it is before you commit. We verify your benefits at no charge, paying at time of service earns a discount, and CareCredit, Affirm and in-office payment plans are available. You only ever pay for care you actually receive — if you paid ahead and the program stops being right for you, the unused portion comes back to you. Cost & Insurance — how the investment works.

The research

What it looks like in numbers

Start with where the research points.

Facet joints get overloaded because the disc in front of them lost height — so the research that matters most here is the research on the disc.

The vacuum effect was measured, not imagined. Researchers publishing in the Journal of Neurosurgery put pressure sensors inside human lumbar discs during decompression and recorded the pressure dropping to −100 to −160 mm Hg1 — a true vacuum, measured inside a living disc.

Herniations shrank more than with a sham treatment. In a randomized trial of real decompression against a sham — so patients couldn't tell which they got — the herniation index fell 27.6% with real treatment against 7.1% with sham, with better leg pain and disability scores at follow-up.3

Discs measurably gained height. Thirty patients scanned before and after a six-week DRX9000 program showed average disc height rising 7.5 mm → 8.8 mm, with pain falling 6.2 → 1.6 out of 10 — and the two changes tracked together.2

Leg pain responded most. In 73 patients compared against physiotherapy plus conventional traction, radiating leg pain and disc height improved far more with decompression.5

Across working clinics. The largest recent series followed 267 patients across multiple clinics: average pain fell from 6.9 to 2.5, with measurable improvement in reflexes and daily function.4

A vacuum measured inside the disc, discs regaining height, herniations shrinking more than sham, and leg pain responding most. Every figure here is from a named, published study. The research behind decompression.

What the change looks like on MRI

Before-and-after sagittal lumbar MRI scans shown side by side, with the disc visibly reduced in the second scan.
Before and after, side-on. Imaging is how disc change is measured in the studies on this page — and how your own progress gets shown to you rather than described to you.
Before-and-after axial lumbar MRI scans of the same patient, seen from above, with a red arrow marking the same spot on each.
The same disc from above — the arrow marks the same spot on both scans, before and after a course on the DRX9000.

Who you'll see

Your care team

We work as a team. Dr. Barton and Dr. Huffman have practiced side by side for more than 18 years, and your care is a team effort from your first visit.

Dr. Kevin S. Barton, D.C.

Kevin S. Barton, D.C.

Chiropractor · In practice since 2003

Dr. Barton has been in practice since 2003 and has used the DRX9000 since 2005, with more than 2,000 patients treated on it. He's the author of the treatment philosophy here: find the source of the pain and treat it there, without surgery and without narcotics. He completed advanced scrambler therapy training in Rome with Dr. Giuseppe Marineo, the inventor of the treatment.

In 2025 he went through the DRX9000 program himself, for one of the worst herniated discs he'd seen in his career, and filmed the whole course of treatment, MRIs included. Watch his nine-part series.

Dr. Joshua C. Huffman, D.C.

Joshua C. Huffman, D.C.

Chiropractor · In practice since 2007

Dr. Huffman earned his Doctor of Chiropractic degree from Texas Chiropractic College in Pasadena, Texas, and completed his internship at Moody Health Center, with a rotation at the Michael E. DeBakey VA Medical Center in Houston. He has advanced training in myofascial release technique and is certified as a designated doctor for the State of Texas.

A Texas native, he was born and raised in Matagorda County. When he isn't getting patients well, he's hunting, fishing, kayaking and hiking with his wife, Kendra, and their two children, Titus and Alley.

How the program runs

Decompression and strengthening, together

Taking the load off the joint is one part of the program. If that were all we did, you'd feel good and then walk back into the same standing, arching, all-day habits that loaded the segment in the first place. So alongside it we rebuild what Dr. Barton calls your structural margin — the strength and the movement habits that keep the joint out of the position it hates. It isn't optional; it's the reason the result holds.

The strengthening phase. As the pain settles, the program shifts toward rebuilding the support around the segment — deep core, glutes, hip flexibility, and the movement patterns that keep your low back out of the arched position all day. This is the part that keeps the load off once your decompression sessions are finished, and it's why we describe one program with two phases rather than a course of "decompression sessions."

Re-exams, on purpose. You get a real reassessment around the second week — the real checkpoint — and again at the end of the program. Not a sales meeting. A measurement: positions, ranges, what you can do now that you couldn't.

What maintenance means here, and what it doesn't. It does not mean signing up for a lifetime of visits. The program has a defined endpoint; optional maintenance is available for those who want it, recommended with a reason — never as an open-ended default. For most facet patients it means a short home program you actually own — two or three hip and core exercises, and a handful of standing habits that cost you nothing:

  • Put one foot up on something when you stand at the sink. A step, a low shelf, the open cabinet under the counter. It flattens your low back and takes the load off. It's the same reason bars have foot rails.
  • Use a step stool for the high shelf instead of arching under it.
  • Break up standing. Shift your weight, change positions, sit for two minutes before the ache arrives instead of after.
  • Keep the hips loose. Tight hip flexors are the quiet tax on every hour you spend upright.

And a flare plan. Facet joints can get loud again after a heavy weekend. You'll know what that is, what to do about it, and when it's worth a call — rather than assuming everything has come undone.

The rehabilitation room at Texas Spine Clinic: therapy tables, a stationary bike, exercise balls and training equipment.
The rehab room. Hips, deep core, glutes and the standing habits that keep the load off — the strengthening runs through your decompression sessions and carries on after they end.

On Google

What patients say

4.6 out of 5 · 112 reviews on Google
“Dr. Barton here at the Texas Spine Clinic is great, he took the time to reach out and have me come in for a consultation and treatment. I have been having issues with my lower back and he got me seen and treated in a very timely manner.”
Jerry Gonzales · Posted on Google
“My experience was amazing… now no pain at all. The team is very professional and understanding. Dr. Huffman was great in explaining the process.”
Roxanna Morales · Posted on Google

Reviews quoted verbatim from our public Google profile.

Questions patients actually ask

Before you call

How is this different from a disc problem?

Opposite loading pattern. Discs get loaded when you sit and bend forward; facets get loaded when you stand and arch back. So the disc patient can't sit through a movie, and you can't stand through a line. Plenty of people have both — and a worn disc is usually why the facets are jammed — which is exactly why treating only one side of that pair disappoints.

My facet injection wore off. Why wouldn't I just get another one?

Maybe you should, and that's a real conversation with the physician who did it. But know what that shot already accomplished: it identified the guilty joint. That's genuinely valuable information, and it's the most valuable thing a block does. What it can't do is change why that joint is overloaded — so when the medication clears, the mechanics are exactly where you left them. Repeating the same short-lived shot indefinitely isn't a plan, it's a subscription. The question worth asking is what's loading the joint, and whether that can be changed.

Do you do the injections here?

Yes — interventional pain management is part of this practice, with a physician performing the injections. Which is exactly why you can trust the recommendation: when the exam says your problem is mechanical — an overloaded segment that needs unloading and the support rebuilt around it — we say that, and it isn't because it's all we have. And if your case genuinely needs a block or an injection first, we'll say that instead. The exam decides, not the menu.

I was told about burning the nerves — radiofrequency ablation. Thoughts?

It's a real procedure done by real physicians, and for some patients it's the right call. It works by interrupting the small nerve that reports pain from a facet joint — the joint stays exactly as it is, but its signal stops arriving at the brain. Two things worth understanding before you agree to it: the nerve regrows over time, which is why the procedure gets repeated, and the load on the joint is unchanged the whole way through. Ask the physician performing it how long relief typically lasts in cases like yours — that's their number to give, not ours. We're not here to disparage it — just to make sure you walk in knowing what it does and what it doesn't.

Can facet arthritis be reversed?

Worn cartilage doesn't grow back, and we won't tell you otherwise. What changes is the load on the joint and the noise from it — and that's the difference between "arthritis on a report" and "arthritis that runs your day."

Can facet joints cause pain down my leg?

Yes — into the buttock and thigh, usually stopping above the knee, because the joint shares nerve wiring with that territory. What facets don't usually do is the electric, lightning, runs-to-the-toes pain of a compressed nerve root. If your leg lights up past the knee, or you have numbness or weakness, that's a different conversation and we'll examine for it. Sciatica.

My report says facet arthropathy. Is that why I hurt?

Maybe. Wear in these joints is close to universal on imaging past 50, including in people with no pain at all. That's why we examine you first and read the film second — the report describes the terrain, the exam tells us what's talking.

Will I have to keep coming forever?

No. The program has a defined endpoint and real re-exams along the way, including an straight assessment at about two weeks. What follows is a short home program you own — hips, core, and a few standing habits. If anyone in this field tells you the answer is visits for life, that's a business model, not a treatment plan.

Does insurance cover it?

The decompression program isn't a covered benefit under any plan. If you carry a commercial health plan, we can usually generate an insurance credit through it, which we apply against your cost. How big that credit is depends on your specific benefits. So expect an out-of-pocket investment, and expect to know exactly what it is, in writing, before you commit to anything. You only ever pay for care you actually receive. Cost & Insurance.

Footnotes

  1. Ramos & Martin, J Neurosurgery 1994 — intradiscal pressure during vertebral axial decompression (−100 to −160 mm Hg). ↩
  2. Apfel et al., BMC Musculoskeletal Disorders 2010 — disc height with the DRX9000. ↩
  3. Choi et al., Int J Clinical Practice 2022 — randomized sham-controlled trial. ↩
  4. Schueren et al., Military Medicine 2025 — 267-patient multi-clinic series. ↩
  5. El-Zayat et al., Egyptian Rheumatology & Rehabilitation 2019 — decompression vs. physiotherapy with traction. ↩

Full citations on the evidence page.

The ask

Find out whether your facets are the ones talking.

Call (210) 741-9166 or send the form. The consultation is $49 — and it isn't a sales pitch. Here's exactly what happens:

  1. You come in for an evaluation. Bring your imaging if you have it, and bring the questions you've been saving. If you don't have imaging, we'll refer you for it — an MRI (or a CT if you can't have an MRI) is required before anyone is treated here.
  2. We examine you — including the simple positional tests that make facet pain show its hand — and then we sit down and go through your films with you, on a screen, together: the pictures, not just the report.
  3. You get one of three straight answers: this is something we can treat, this belongs with a different kind of physician, or this needs watching and here's how. Two of those three answers earn us nothing, and we give them out constantly.
  4. If the answer is yes, your first treatment is included. The $49 covers the examination, the imaging review and your first session on the table. If the answer is no, it's no.

Either way, you'll leave understanding your own spine better than you did walking in.

Call (210) 741-9166 Request a consultation

Book your $49 consultation

No referral needed. Same-day appointments available.

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Rather book by phone? Call (210) 741-9166.

P.S. For a while now you've been quietly editing your life around a joint nobody explained to you. Shorter trips to the store. A chair scouted before you commit to standing. Skipping the thing you'd have to stand through. Here's the part worth holding onto: you've already run the experiment a hundred times, and it came back with a clear result — standing loads it, sitting unloads it. That's not a mystery, and it isn't just age. It's a load problem, and load is something that can be changed. One evaluation tells you whether yours is one of the ones we can change.