Facet joint injections are minimally invasive procedures used to diagnose and treat pain arising from the small joints of the spine. These joints help stabilize the vertebrae and allow controlled movement, but they can become inflamed or painful because of arthritis, injury, repetitive strain, or age-related degeneration.
At TOPS Institute, our board-certified interventional pain management specialists perform precise, image-guided facet joint injections for patients with chronic neck pain, lower back pain, and pain related to spinal arthritis.
Our goal is to identify the true source of your symptoms, reduce inflammation, improve mobility, and help you return to daily activities with less discomfort.
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What Is a Facet Joint Injection?
A facet joint injection is a targeted procedure in which a small amount of local anesthetic, corticosteroid medication, or a combination of both is delivered directly into or around a painful facet joint.
The facet joints are paired joints located along the back of the spine. They connect one vertebra to the next and help guide bending, twisting, and extension.
When a facet joint becomes irritated or arthritic, it may cause:
- Localized neck or back pain
- Pain that worsens with extension or rotation
- Stiffness
- Muscle tightness
- Reduced range of motion
- Referred pain into the shoulders, buttocks, or thighs
Facet joint injections can serve both a diagnostic and therapeutic purpose.
If pain improves after the local anesthetic is injected, this may help confirm that the targeted joint is contributing to the patient’s symptoms. The corticosteroid component may then reduce inflammation and provide longer-lasting relief.
What Are Facet Joints?
Facet joints are small, cartilage-lined joints located on both sides of each vertebra. They help stabilize the spine while allowing smooth, controlled movement.
Like other joints in the body, facet joints may be affected by:
- Osteoarthritis
- Cartilage breakdown
- Repetitive strain
- Traumatic injury
- Degenerative disc disease
- Abnormal spinal mechanics
- Previous spine surgery
- Age-related wear and tear
When these joints become inflamed, the condition is often referred to as facet joint syndrome, facet arthropathy, or spinal arthritis.
Conditions Treated With Facet Joint Injections
Facet joint injections may be considered for patients with:
- Cervical facet joint pain
- Lumbar facet joint pain
- Facet joint arthritis
- Facet arthropathy
- Cervical spondylosis
- Lumbar spondylosis
- Degenerative disc disease
- Mechanical neck pain
- Mechanical lower back pain
- Whiplash-related facet pain
- Pain after spinal injury
- Persistent pain following spine surgery
Facet joint injections are generally most appropriate when symptoms and imaging findings suggest that the facet joints may be the source of pain.
Cervical Facet Joint Injections
Facet Injections for Chronic Neck Pain
A cervical facet joint injection targets one or more painful facet joints in the neck. These joints can become irritated because of arthritis, poor posture, whiplash, repetitive strain, or degeneration of the cervical spine.
Cervical facet pain often causes discomfort in the neck but may also refer pain into the:
- Shoulders
- Upper back
- Base of the skull
- Shoulder blades
- Upper arms
Common symptoms of cervical facet joint pain include:
- Neck pain that worsens with turning
- Pain with looking upward
- Neck stiffness
- Headaches originating near the base of the skull
- Tenderness along the cervical spine
- Reduced range of motion
- Pain after whiplash or other neck injury
During the procedure, the physician uses fluoroscopic guidance to position a thin needle near or within the affected facet joint. Contrast dye may be used to confirm accurate placement before medication is delivered.
Cervical facet injections may provide temporary pain relief and can also help determine whether the facet joint is the primary source of symptoms.
Lumbar Facet Joint Injections
Facet Injections for Lower Back Pain
A lumbar facet joint injection targets painful joints in the lower spine. Lumbar facet pain is often caused by arthritis, degeneration, repetitive stress, injury, or abnormal movement of the spine.
Pain may remain localized in the lower back or refer into the:
- Buttocks
- Hips
- Groin
- Upper thighs
Unlike sciatica, lumbar facet pain usually does not follow a clear nerve-root pattern below the knee.
Common symptoms of lumbar facet joint pain include:
- Aching lower back pain
- Pain with standing
- Pain with spinal extension
- Pain when twisting
- Stiffness after inactivity
- Tenderness over the lower spine
- Pain that improves with sitting or bending forward
Lumbar facet joint injections are performed under fluoroscopic guidance to ensure accurate needle placement and medication delivery.
They may be used to relieve pain, confirm the diagnosis, and determine whether a patient may benefit from additional treatment such as medial branch blocks or radiofrequency ablation.
Facet Joint Injection vs. Medial Branch Block
Facet joint injections and medial branch blocks are related but different procedures.
Facet Joint Injection
Medication is placed directly into or around the facet joint.
This procedure may be used to:
- Reduce joint inflammation
- Provide therapeutic pain relief
- Help confirm the joint as a pain source
Medial Branch Block
A medial branch block targets the small nerves that transmit pain signals from the facet joints.
This procedure is often performed as a diagnostic test before radiofrequency ablation.
If a patient experiences significant temporary relief after one or more medial branch blocks, radiofrequency ablation may be considered for longer-lasting pain control.
Why Are Facet Joint Injections Performed?
Targeted Pain Relief
Facet joint injections deliver medication directly to the suspected source of inflammation, reducing the need for widespread medication exposure.
Diagnostic Information
Temporary improvement following the injection may help confirm that the facet joint is contributing to the patient’s pain.
Reduced Inflammation
Corticosteroid medication may decrease inflammation and irritation within the joint.
Improved Mobility
Reducing pain and stiffness can make it easier to turn the neck, bend, walk, exercise, and participate in physical therapy.
Non-Surgical Treatment
Facet injections require no surgical incision and are generally performed on an outpatient basis.
What Happens During a Facet Joint Injection?
Facet joint injections are usually performed in an outpatient setting.
The procedure generally includes:
- Medical review: Your physician reviews your symptoms, imaging studies, medications, allergies, and medical history.
- Positioning: You are positioned on the procedure table according to the region being treated.
- Sterile preparation: The skin is cleaned, and local anesthetic is used to numb the treatment area.
- Image guidance: Fluoroscopy is used to guide the needle toward the targeted facet joint.
- Contrast confirmation: A small amount of contrast dye may be used to confirm proper positioning.
- Medication delivery: Local anesthetic and, when appropriate, corticosteroid medication are administered.
- Observation: You are monitored briefly before returning home.
The injection itself may take only several minutes, although the full appointment is longer because of preparation and observation.
How Long Does Pain Relief Last?
The duration of relief varies from patient to patient.
Some patients experience:
- Temporary relief lasting several hours from the anesthetic
- Improvement lasting several days or weeks
- Longer relief lasting several months
The response depends on:
- The severity of joint degeneration
- The number of joints treated
- Whether the injection is primarily diagnostic or therapeutic
- The patient’s overall health
- Participation in physical therapy
- Previous response to treatment
A facet joint injection is not guaranteed to provide long-term relief, but the response may help guide the next stage of care.
What Happens If the Injection Works?
If the injection produces meaningful but temporary relief, your physician may recommend:
- Physical therapy
- Activity modification
- Core or cervical stabilization exercises
- Repeat diagnostic medial branch blocks
- Radiofrequency ablation
- Additional evaluation if symptoms return
Radiofrequency ablation may provide longer-lasting relief by interrupting pain signals from the medial branch nerves supplying the painful facet joints.
Learn more about Radiofrequency Ablation.
Benefits of Facet Joint Injections
Effective Pain Management
Facet injections may reduce chronic neck or back pain caused by spinal arthritis, inflammation, or degeneration.
Minimally Invasive
The procedure requires no incision and typically involves limited downtime.
Improved Function
Pain reduction may make walking, working, sleeping, and participating in rehabilitation more manageable.
Diagnostic Precision
Facet injections can help identify whether one or more facet joints are contributing to the patient’s symptoms.
Customized Treatment Planning
The patient’s response provides useful information for determining whether additional procedures may be appropriate.
Recovery After a Facet Joint Injection
Most patients return home the same day.
Temporary effects may include:
- Mild soreness
- Pressure at the injection site
- Temporary numbness
- Brief pain flare
- Mild weakness related to local anesthetic
General aftercare may include:
- Resting for the remainder of the day
- Avoiding strenuous activity for a short period
- Monitoring the injection site
- Resuming medications as instructed
- Tracking the level and duration of pain relief
Patients who receive sedation generally need someone to drive them home.
Are Facet Joint Injections Safe?
Facet joint injections are generally considered safe when performed by an experienced physician using fluoroscopic guidance.
Potential risks include:
- Temporary increased pain
- Bleeding
- Infection
- Allergic reaction
- Steroid-related side effects
- Temporary numbness or weakness
- Elevated blood sugar
- Nerve irritation or injury
- Rare vascular or neurological complications
Patients taking blood-thinning medication, those with active infection, uncontrolled diabetes, bleeding disorders, or certain medical conditions may require additional evaluation.
Do not stop prescribed blood-thinning medication unless your treating physicians have provided coordinated instructions.
Who Is a Good Candidate?
You may be a candidate for a facet joint injection if you have:
- Chronic neck or lower back pain
- Pain that worsens with extension or rotation
- Imaging showing facet degeneration or arthritis
- Pain that has not improved with conservative care
- Symptoms that limit physical therapy
- A suspected facet joint pain pattern
Facet injections are not appropriate for every type of spinal pain. Pain caused primarily by nerve-root compression, large disc herniation, fracture, infection, or spinal cord compression may require a different treatment approach.
When Should You Seek Immediate Medical Care?
Seek urgent evaluation for spinal pain accompanied by:
- New loss of bladder or bowel control
- Rapidly worsening weakness
- Saddle-area numbness
- Fever with severe back or neck pain
- Significant trauma
- Loss of balance or coordination
- Symptoms of spinal cord compression
These symptoms may indicate a serious condition that should not be treated with a routine facet injection alone.
Facet Joint Injections vs. Epidural Steroid Injections
Facet joint injections target the joints located along the back of the spine.
Epidural steroid injections target inflammation around spinal nerve roots in the epidural space.
Facet injections are generally used for:
- Axial neck or back pain
- Pain with extension or rotation
- Spinal arthritis
- Facet arthropathy
Epidural injections are more commonly used for:
- Sciatica
- Cervical radiculopathy
- Lumbar radiculopathy
- Herniated discs
- Radiating arm or leg pain
The correct procedure depends on the source and pattern of your symptoms.
Learn more about Epidural Steroid Injections.
Related Treatments
Medial Branch Blocks
Diagnostic medial branch blocks temporarily numb the nerves supplying the facet joints and may help determine whether radiofrequency ablation is appropriate.
Radiofrequency Ablation
Radiofrequency ablation uses controlled heat to interrupt pain signals from the medial branch nerves and may provide longer-lasting relief for confirmed facet joint pain.
Epidural Steroid Injections
Epidural injections are used for nerve-root inflammation, sciatica, and radiating arm or leg pain.
Physical Therapy
Rehabilitation can improve spinal mobility, posture, core strength, and long-term function.
Why Choose TOPS Institute?
At TOPS Institute, we provide advanced, personalized treatment for cervical and lumbar facet joint pain.
Patients choose our practice for:
- Board-certified interventional pain management specialists
- Fluoroscopic image guidance
- Comprehensive diagnostic evaluations
- Cervical and lumbar spine expertise
- Personalized treatment planning
- Minimally invasive procedures
- Concierge-level patient support
- Convenient care in Los Angeles and Beverly Hills
- A focus on mobility, function, and long-term relief
Our physicians carefully determine whether your symptoms are caused by the facet joints before recommending treatment. We do not use a one-size-fits-all approach.
Frequently Asked Questions
What is a facet joint injection?
A facet joint injection is a minimally invasive procedure that places anesthetic and, when appropriate, corticosteroid medication into or around a painful spinal joint. It may reduce inflammation and help identify whether the joint is causing pain.
What conditions can facet joint injections treat?
Facet injections may be used for cervical or lumbar facet arthropathy, spinal arthritis, spondylosis, mechanical neck pain, mechanical lower back pain, and pain caused by injury or degeneration.
What is a cervical facet joint injection?
A cervical facet joint injection targets a painful joint in the neck. It may be used for neck pain, stiffness, headaches originating from the upper neck, or referred pain into the shoulders and upper back.
What is a lumbar facet joint injection?
A lumbar facet joint injection targets a painful joint in the lower spine. It may help relieve localized lower back pain or referred pain into the buttocks, hips, or upper thighs.
How is a facet joint injection different from an epidural injection?
Facet injections target the spinal joints. Epidural injections target inflammation around spinal nerves and are more commonly used for sciatica or radiating arm or leg pain.
Is a facet joint injection painful?
Most patients feel pressure or brief discomfort. Local anesthetic is used to numb the skin, and the procedure is performed under image guidance.
How quickly do facet joint injections work?
The local anesthetic may provide relief within hours. The corticosteroid may take several days or longer to produce its full effect.
How long does pain relief last?
Relief may last from several hours to several months. The response varies depending on whether the injection is diagnostic, therapeutic, or both.
What happens if the injection provides only temporary relief?
Temporary but meaningful relief may indicate that the facet joint is the pain source. Your physician may then recommend medial branch blocks, radiofrequency ablation, physical therapy, or another targeted treatment.
Are facet joint injections safe?
They are generally safe when performed by trained specialists using image guidance. Potential risks include bleeding, infection, temporary pain, allergic reaction, steroid-related effects, and rare nerve or vascular complications.
How many facet joint injections can I receive?
The appropriate number depends on your diagnosis, prior response, steroid exposure, health history, and physician judgment. Treatment should be individualized rather than scheduled automatically.
How much does a facet joint injection cost in Los Angeles?
Cost varies based on the number of joints treated, the spinal region, facility fees, imaging guidance, sedation, and insurance coverage. Our office can help review available cost and coverage information before treatment.
Take the First Step Toward Pain Relief
Chronic neck or lower back pain can make even routine activities difficult. If spinal arthritis or facet joint inflammation is contributing to your symptoms, an image-guided facet joint injection may provide meaningful relief and valuable diagnostic information.
Contact TOPS Institute to schedule a comprehensive evaluation with an interventional pain management specialist in Los Angeles or Beverly Hills.
Book an Appointment Today
