Which lumbar spine condition presents with localized LBP that is worse with extension and rotation?

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Pain coming from the facet joints in the lumbar spine tends to be localized to the back and is triggered by movements that load the posterior elements, especially extension and rotation. Extending the spine closes and compresses the facet joints, while rotating places stress on them as well, so arthritic or inflamed facet joints produce sharp, localized low back pain that worsens with these motions. There are usually no leg symptoms or neurological findings with this pattern, which helps distinguish it from nerve root problems.

Radiculopathy would show leg pain, numbness, or weakness in a dermatomal distribution. Spondylolisthesis can cause low back pain and mechanical instability, sometimes with extension-related symptoms, but it often presents with signs of vertebral slippage and possible neuro involvement. Sacroiliac dysfunction usually causes buttock or hip pain and is provoked by SI joint-specific maneuvers, not simply extension-rotation of the lumbar spine.