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.
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:
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.
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:
When these joints become inflamed, the condition is often referred to as facet joint syndrome, facet arthropathy, or spinal arthritis.
Facet joint injections may be considered for patients with:
Facet joint injections are generally most appropriate when symptoms and imaging findings suggest that the facet joints may be the source of 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:
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.
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:
Unlike sciatica, lumbar facet pain usually does not follow a clear nerve-root pattern below the knee.
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 injections and medial branch blocks are related but different procedures.
Medication is placed directly into or around the facet joint.
This procedure may be used to:
Facet-mediated pain is often described as axial low back pain, meaning the discomfort is centered primarily in the spine rather than traveling down the leg along a nerve.
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.
Facet joint injections deliver medication directly to the suspected source of inflammation, reducing the need for widespread medication exposure.
Temporary improvement following the injection may help confirm that the facet joint is contributing to the patient’s pain.
Corticosteroid medication may decrease inflammation and irritation within the joint.
Reducing pain and stiffness can make it easier to turn the neck, bend, walk, exercise, and participate in physical therapy.
Facet injections require no surgical incision and are generally performed on an outpatient basis.
Facet joint injections are usually performed in an outpatient setting.
The procedure generally includes:
The injection itself may take only several minutes, although the full appointment is longer because of preparation and observation.
The duration of relief varies from patient to patient.
Some patients experience:
The response depends on:
A facet joint injection is not guaranteed to provide long-term relief, but the response may help guide the next stage of care.
If the injection produces meaningful but temporary relief, your physician may recommend:
Radiofrequency ablation may provide longer-lasting relief by interrupting pain signals from the medial branch nerves supplying the painful facet joints.
Facet injections may reduce chronic neck or back pain caused by spinal arthritis, inflammation, or degeneration.
The procedure requires no incision and typically involves limited downtime.
Pain reduction may make walking, working, sleeping, and participating in rehabilitation more manageable.
Facet injections can help identify whether one or more facet joints are contributing to the patient’s symptoms.
The patient’s response provides useful information for determining whether additional procedures may be appropriate.
Most patients return home the same day.
Temporary effects may include:
General aftercare may include:
Patients who receive sedation generally need someone to drive them home.
Facet joint injections are generally considered safe when performed by an experienced physician using fluoroscopic guidance.
Potential risks include:
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.
You may be a candidate for a facet joint injection if you have:
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.
Seek urgent evaluation for spinal pain accompanied by:
These symptoms may indicate a serious condition that should not be treated with a routine facet injection alone.
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:
Epidural injections are more commonly used for:
The correct procedure depends on the source and pattern of your symptoms.
Diagnostic medial branch blocks temporarily numb the nerves supplying the facet joints and may help determine whether radiofrequency ablation is appropriate.
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 injections are used for nerve-root inflammation, sciatica, and radiating arm or leg pain.
At TOPS Institute, we provide advanced, personalized treatment for cervical and lumbar facet joint pain.
Patients choose our practice for:
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.
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.
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.
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.
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.
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.
Most patients feel pressure or brief discomfort. Local anesthetic is used to numb the skin, and the procedure is performed under image guidance.
Relief may last from several hours to several months. The response varies depending on whether the injection is diagnostic, therapeutic, or both.
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.
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.
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.
For appropriately selected patients whose diagnostic blocks support facet-mediated pain, lumbar radiofrequency ablation may be considered to provide longer-lasting reduction in pain signals from the affected joints.
Persistent lower back pain can originate from many different structures, and imaging alone may not identify which one is actually responsible.
A lumbar medial branch block can help determine whether the facet joints are contributing to your pain and whether a longer-lasting treatment such as radiofrequency ablation may be appropriate.
Schedule a consultation with TOPS Institute in Los Angeles or Beverly Hills for evaluation of chronic low back pain and suspected lumbar facet-mediated pain.
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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.
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640 South San Vicente Blvd., Suite 389, Los Angeles, CA 90048
Interventional pain management for Los Angeles & Beverly Hills — image-guided care that treats the source, not just the symptom.
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