A facet joint injection targets the small joints that connect the vertebrae at the back of your spine. When these joints become inflamed or arthritic, they can cause stiff, aching pain in the lower back or neck. The injection delivers medication into or near the joint to reduce pain, and it can also help confirm whether that joint is the source of your pain.
Each vertebra connects to the next through a pair of facet joints, one on each side. These joints guide how your spine bends and twists. Like other joints, they have cartilage and a lining that can wear down or become inflamed over time, especially with arthritis, injury or repetitive strain.
A facet joint injection places a local anesthetic, often combined with a steroid, into the joint itself (an intra-articular injection) or next to the small nerves that carry pain signals from the joint (a medial branch block).
Because facet pain can feel similar to pain from discs or muscles, the injection also serves as a test. If your pain eases significantly after the numbing medication, that suggests the facet joint is involved. That information helps your provider decide on next steps, which may include radiofrequency ablation for longer-lasting relief. → /treatments/radiofrequency-ablation/
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Your provider may recommend a facet joint injection for:
facet arthropathy or spondylosis
that stays in the back and worsens when you lean backward, twist or stand for a long time
Learn about Low Back Pain
that feels stiff and localized, sometimes with headaches at the base of the skull
Learn about Neck Pain
That has not improved with conservative care
Facet pain usually doesn’t travel below the knee or into the hand. Pain that shoots down a limb is more often nerve-related, and an epidural steroid injection may be more appropriate. Learn about Epidural Steroid Injection
Treats the facet joints in the lower back. It’s often considered for chronic low back pain that feels worse after standing or bending backward.
Treats the facet joints in the neck. It may help with neck stiffness, pain when turning your head and some types of headaches that start in the neck.
A facet joint injection may be considered if:
Your provider will decide whether a facet joint injection is appropriate after an evaluation. It may not be recommended if you have an infection, a bleeding disorder or certain allergies, or if you’re pregnant.
Your provider reviews your medical history and medications, including blood thinners. You may be asked to note your pain level before the procedure so you can compare it afterward.
You’ll lie face down. The skin is cleaned and numbed, and your provider uses imaging guidance to direct a thin needle to the joint or the nerves next to it before injecting the medication.
You’ll be asked to move in ways that normally cause pain and to track how you feel over the next several hours. That record helps your provider interpret the results. You’ll go home the same day.
Most people return to regular activity within a day, following their provider’s instructions. The numbing medication can bring quick, temporary relief. If a steroid is included, it may take a few days to work.
How long relief lasts varies from person to person. If an injection helps but the relief doesn’t last, your provider may discuss radiofrequency ablation or a structured physical therapy program.
Possible side effects include temporary soreness, a short-term increase in pain and, if a steroid is used, flushing, trouble sleeping or temporarily higher blood sugar. Rare complications include infection, bleeding and nerve irritation. Your provider will review your specific risks before the procedure.
Contact our office if you develop fever, increasing pain or new weakness after your injection.
Facet joint injections are often covered when medically necessary, sometimes with prior authorization or documentation of previous treatments. We’ll help you check your benefits.
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The skin is numbed first. Most people describe pressure and brief discomfort. Mild soreness afterward is common and usually fades within a day or two.
It varies. The anesthetic wears off within hours. If a steroid is included, relief may last weeks or months for some people and less for others.
A facet joint injection puts medication inside the joint. A medial branch block numbs the small nerves that carry pain from the joint. Both can help identify the source of pain, and a medial branch block is often used before radiofrequency ablation.
That’s useful information too. It suggests your pain may come from somewhere else, such as a disc, a nerve or the sacroiliac joint, and your provider will adjust your plan.
Schedule an evaluation at our Rego Park, Queens office to see whether a facet joint injection may be right for you.
