Chronic back and neck pain can be incredibly frustrating, especially when it limits your ability to work, sleep, or enjoy daily activities. For many people, the cause of this discomfort can be traced to the small but important joints in the spine known as facet joints.
When these joints become inflamed or irritated, they can cause localized pain or even radiate discomfort to other parts of the body.
Fortunately, there are solutions available that can provide meaningful relief. One of the most effective options is a facet joint injection — a targeted treatment that can offer pain relief and help determine the root cause of spinal discomfort. Whether you’re exploring this option for yourself or helping a loved one make informed decisions about pain management, understanding what to expect is essential.
That’s why we’re walking you through everything you need to know about facet joint injections: how they work, when they’re used, what the procedure involves, and why choosing the right pain management specialist is key to your recovery journey.
Understanding Facet Joint Injections
If you’re dealing with persistent spine pain and have been told that facet joints might be the source, understanding how facet joint injections work is a key step toward finding relief. Here are the basics on facet joints, how facet injections work, and the types of conditions they’re commonly used to treat.
What Are Facet Joints?
Facet joints are small stabilizing joints located between and behind adjacent vertebrae in the spine. These joints provide flexibility and movement in the neck and back while also maintaining spinal stability. Like other joints in the body, facet joints are lined with cartilage and surrounded by a capsule filled with synovial fluid.
Over time, facet joints can become damaged or inflamed due to injury, arthritis, repetitive strain, or degenerative changes. When this happens, they may become a source of chronic neck or back pain.
What Is a Facet Joint Injection?
A facet joint injection is a minimally invasive procedure where a mixture of anesthetic and anti-inflammatory medication is injected. The active agent is typically a corticosteroid, and it will be injected directly into the facet joint or the surrounding area, which is known as a medial branch block.
The injection can serve two primary purposes:
- Diagnosis: If the injection relieves your pain, it can confirm that the facet joints are the source of your discomfort. In contrast, if pain persists, it can tell physicians that there may be another source of symptoms.
- Treatment: The steroid component reduces inflammation in the facet joint, providing longer-term pain relief and improved mobility that can last weeks or even months.
Conditions Treated with Facet Joint Injections
Facet joint injections are commonly used to manage pain associated with:
- Osteoarthritis: This is a very common degenerative condition where the cartilage in the joints wears down, leading to joint inflammation and chronic pain. When this condition occurs in the facet joints, it is known as facet joint syndrome.
- Spondylosis: Also known as spinal degeneration or degenerative spine disease, this is age-related wear and tear on the spinal discs and joints that can cause stiffness, nerve irritation, and discomfort.
- Spinal stenosis: A narrowing of the spinal canal that puts pressure on the spinal cord and nerves, often leading to pain, numbness, or weakness.
- Whiplash injuries: Neck injuries caused by sudden, forceful back-and-forth movement, commonly from car accidents, that can strain or damage the facet joints.
- Post-laminectomy syndrome: Also known as failed back surgery syndrome, this is persistent pain following spine surgery, often due to scar tissue or residual inflammation affecting the facet joints.
- Chronic neck or lower back pain: Ongoing pain without a clear structural cause that hasn’t improved with medications, therapy, or lifestyle changes, sometimes linked to facet joint dysfunction.
These injections can be performed in the cervical (neck), thoracic (mid-back), or lumbar (lower back) regions of the spine, depending on where the pain is located.
10 Important Facts to Know About Facet Joint Injections
Before deciding whether facet joint injections are right for you, it’s important to understand how they work, what benefits they offer, and what you can expect throughout the process. Below are some of the most important things to know — covering everything from how the procedure is performed to how it fits into a broader pain management plan.
1. They’re Minimally Invasive
One of the biggest benefits of facet joint injections is that they are non-surgical and minimally invasive. The procedure is performed using a thin needle, guided by imaging technology such as fluoroscopy, which is essentially a real-time X-ray, or CT scan to ensure accuracy.
Since there are no incisions or stitches, the risk of infection or complications is very low, and most people are in and out of the clinic on the same day.
2. They Offer Fast Recovery and Minimal Downtime
Most patients can return to light activity within 24 hours of the procedure. Unlike surgery, which may require weeks or even months of rehabilitation, facet joint injections are associated with quick recovery times. Some people even return to work the next day, depending on their physical activity levels.
That said, strenuous activity or heavy lifting should be avoided for a few days to allow the medication to settle and reduce the risk of irritation.
3. They Can Be Used Alongside Physical Therapy
Facet joint injections are often part of a multimodal treatment plan, which may include:
- Physical therapy
- Chiropractic care
- Massage therapy
- Exercise and stretching routines
In fact, pain relief from the injection can make it easier for patients to participate in physical therapy, helping strengthen the muscles around the spine and reduce long-term discomfort.
4. They Are Often an Alternative to Surgery
For patients trying to avoid spinal surgery, facet joint injections can be an effective intermediate step. If pain is manageable and responds well to the injections, more invasive options like spinal fusion or decompression surgery may be postponed or avoided entirely.
This makes injections a valuable option for those who are not candidates for surgery due to age, medical conditions, or personal preference.
5. Pain Relief Duration Varies
While many people report pain relief that is still significant at three months, others may only get relief for a few weeks. On average, the benefits of facet joint injections last anywhere from three to six months, depending on the individual and the severity of the condition.
For longer-term management, some patients may receive periodic injections as part of a structured pain management plan.
6. They’re Usually Considered After Conservative Treatments
Facet joint injections are not typically the first line of treatment. Most physicians will recommend trying conservative measures first, such as:
- Over-the-counter pain medications
- Alternating hot and cold, such as an ice pack and a heating pad
- Physical therapy
- Lifestyle changes, such as increasing physical activity and improving nutrition
If a course of initial therapy does not offer relief, or if the pain becomes disabling, then facet joint injections may be considered as the next step.
7. The Procedure Is Usually Quick
The entire injection procedure usually takes 15 to 30 minutes, with some additional time for observation afterward.
Here’s what to expect during the procedure:
- Patients lie on an exam table, often on their stomachs.
- The skin over the injection site will be cleaned and numbed with a local anesthetic.
- Using imaging guidance, the doctor will carefully insert a needle into the facet joint.
- A small amount of contrast dye may be used to confirm proper placement.
- The steroid and anesthetic mixture is injected.
- After a short observation period, you’ll be discharged to go home.
Most patients report minimal discomfort during the procedure, often describing it as pressure or a brief sting.
8. Initial Relief, Longer-Term Results
Because the injection contains both anesthetic and steroid medication, patients often feel immediate pain relief due to the numbing effect. But it’s important to note that this initial relief wears off after a few hours. After that, the anti-inflammatory longer-term impact of the steroid usually takes two to seven days to begin working.
Patients are advised not to feel discouraged if pain returns briefly before improving again.
9. Risks are Rare
As with any medical procedure, there are risks involved, though they are rare. Possible side effects of facet joint injections can include:
- Temporary soreness at the injection site
- Mild allergic reaction to medications or contrast dye
- Very rare infection
- Bleeding or bruising
- Elevated blood sugar, especially in diabetic patients
Your doctor will review your medical history and medications beforehand to minimize these risks.
10. Facet Joint Injections Can be Used for Diagnosis
As mentioned above, facet joint injections are used not just for relief, but as a diagnostic tool to determine if a patient might benefit from a more lasting treatment. One standard pain relief option for facet joint pain is called radiofrequency ablation (RFA).
RFA is a procedure where targeted nerve endings near the facet joints are gently heated using radio waves, interrupting pain signals from reaching the brain. This can provide relief for six months to over a year. Before performing RFA, many pain specialists use a medial branch block to test whether numbing the nerve reduces pain. If the test is successful, it indicates that RFA may be an appropriate next step.
This process ensures that longer-term procedures are only performed when there’s strong evidence they’ll be effective, improving outcomes and patient satisfaction.
How to Know if Facet Joint Injections Are Right for You
Facet joint injections aren’t for everyone, but they can be highly effective for the right candidates. You might be a good candidate if you:
- Have chronic neck, mid-back, or lower back pain that hasn’t responded well to conservative treatments like physical therapy, medications, or rest.
- Experience pain that tends to worsen with movement, especially twisting, bending, or prolonged standing.
- Have been diagnosed with conditions like facet joint arthritis, spondylosis, or spinal stenosis.
- Need a diagnostic tool to confirm whether your facet joints are the true source of your pain.
- Are looking for a less invasive alternative to spinal surgery or need temporary relief to participate in physical therapy more effectively.
Ultimately, the best way to determine if facet joint injections are right for you is through a thorough evaluation by a qualified pain management or spine specialist. They’ll review your medical history, conduct a physical exam, and may order imaging tests like X-rays or MRIs to pinpoint the source of your discomfort.
Choosing the Right Pain Management Specialist Matters
The most important factor in your success with facet joint injections is choosing an experienced and qualified orthopedic or interventional pain management specialist.
Look for a provider who:
- Is board-certified in pain management, anesthesiology, or orthopedic medicine with an organization such as the American Board of Anesthesiology or the American Board of Pain Medicine
- Has experience performing spinal injections with imaging guidance
- Takes time to explain the procedure and answer your questions
- Works as part of a multidisciplinary team, including physical therapists and surgeons
- Offers a comprehensive treatment plan tailored to your specific needs
Personal rapport and communication also matter. You want someone who listens to your concerns, discusses all your options, and helps you feel comfortable throughout the process.
Find Relief from Facet Joint Pain
Facet joint injections are a valuable tool in the management of chronic spine pain. Whether used to diagnose a problem, reduce inflammation, or help you engage in physical therapy, these injections can offer meaningful relief with minimal risk and downtime.
Understanding the procedure, what to expect, and how it fits into your overall care plan is essential. Equally important is working with a trusted pain management provider who prioritizes your long-term well-being.
If you’ve been living with chronic back or neck pain and are exploring your options, facet joint injections can be a big step toward helping you reclaim your comfort and mobility. Talk to your doctor or schedule a consultation with a spine specialist to see if this treatment is right for you.
At The Orthopedic Clinic, we prioritize compassionate, person-centered orthopedic and pain management care that goes beyond addressing the condition. Our experienced team takes the time to consider your lifestyle and health goals to give you a treatment plan that suits your needs. If you’re dealing with facet joint pain and exploring potential treatment options, we can help you find the relief you deserve. Reach out to us today to explore how we can support your journey to better health.