What Are Facet Joint Injections?

Facet joint injections are a minimally invasive non-surgical treatment that can help with many different causes of neck and back pain. These injections work by reducing the inflammation and irritation in the facet joints of the spine that are causing you pain. They are an increasingly common treatment for those suffering from neck or lower back pain. Before getting facet joint injections for chronic pain, though, it’s important to understand how they work, what conditions they are used for, and any risks associated with treatment.

What Are The Facet Joints?

To understand how facet injections can help with chronic pain, it is first important to know a little bit about the anatomy of the spine. Facet joints are located between each vertebrae of the neck and along the bony ridge of the lumbar spine. They are protected by cartilage and surrounded by synovial fluid. This fluid lubricates the entire joint and reduces friction when these joints move.

Facet joints allow movement in the neck and the lower torso. You may feel movement restrictions when facet joints begin to degenerate due to age. This inflammation can lead to a decrease in the range of motion in the lower back and neck. You may also experience restricted movement if pain originates anywhere along the spine due to injury or another condition.

Facet Joint Anatomy

Could Facet Joint Injections Help Me?

In addition to facet joint degeneration, facet joint injections help treat pain due to the following conditions:

  • Spinal stenosis: A narrowing of the spinal column that places pressure on the nerves of the lower back
  • Arthritis: Wear-and-tear conditions, such as osteoarthritis
  • Whiplash: A neck injury or chronic pain condition often caused by car accidents
  • Injury: Any injury to the facet joints in the lower back can lead to pain and inflammation
  • Herniated discs: Occurs when vertebral disc material is pushed out from in between the vertebrae, allowing bone-on-bone contact and compression of nerves

Facet joint injections can do more than treat pain. They can also help your doctor diagnose an underlying condition. If a facet joint injection works to block your pain, this can be valuable information for your doctor.

Facet injections can also be a temporary treatment that allows you to participate in physical therapy and exercise for long-term relief. Some back pain conditions, for example, require physical therapy to correct the underlying cause of pain. However, your back pain may make exercise impossible. Facet joint injections can relieve pain and inflammation and allow you to begin physical therapy sooner.

Facet joint injections procedure

Facet joint injection benefits

A large evidence-based practice guideline for the management of chronic spinal pain with interventional techniques was developed by the American Society of Interventional Pain Physicians. It provide recommendations to clinicians and patients in the United States. For facet joint injections, they state that the accuracy of facet joint nerve blocks is a strong  benefit in the diagnosis of lumbar and cervical facet joint pain.

With a minimal amount of risks, facet joint injections also provide an appropriate non-surgical treatment for many back pain patients.

How Are Facet Joint Injections Performed?

Facet joint injections are minimally-invasive, outpatient procedures that can be performed in just a couple hours. The procedure itself usually takes less than 15 minutes.

To start, patients usually only receive a local anesthetic, but in some cases they may opt for general sedation. In the case of general sedation, the procedure will take a little longer, as your team must monitor you as you come out of anesthesia. To begin the procedure, patients will lie face down on the examining table. The area to be injected will be cleaned and numbed with a topical numbing agent before a local anesthetic is administered.

The doctor will insert a needle using fluoroscopy to ensure proper placement. Once the needle is in place, guided also by a fluoroscopic dye, an anesthetic and a steroid will be injected into the facet joint. The steroid can reduce the inflammation and irritation and the anesthetic works to numb the pain. The combination medicine then spreads to other levels and portions of the spine, reducing inflammation and irritation.

Facet joint injections and the epidural steroid injections (ESI) are very similar, differing only in the location that they inject the medicine. In an ESI, the medication is injected into the epidural space whereas in facet injections, it is injected directly into the joint. You can watch an epidural steroid injection procedure in the following video.


Facet joint injection risks

As with any procedure, there are risks and potential side effects that may occur. Patients may experience bruising, soreness, and bleeding at the injection site, but most cases will be minor. In rare cases, more severe side effects may occur. These can include:

  • Infection at the injection site
  • Allergic reaction to the steroid or anesthetic
  • Difficulty with sedation
  • Nerve damage

The most severe risks usually involve misplacement of the needle, either advancing the needle too deeply or positioning it incorrectly. To help avoid this situation, work closely with a doctor who has advanced experience administering facet joint injections.

The other risks of facet injections relate to the actual medication given. Side effects from the steroids themselves can include:

  • Weight gain
  • Face flushing or redness
  • Insomnia
  • High blood sugar
  • Stomach ulcers
  • Immune system issues

If you opt for general sedation, there may be additional risks.

Before receiving a facet injection, talk to your doctor about your previous health history. There are some people who may have a higher risk of complications. People in poor health or with a poorly managed health condition may not be good candidates for facet joint injections. Because facet joint injections can elevate blood sugar, patients with diabetes should be careful.


Facet joint injections can provide rapid pain relief. With this, patients can become active again and resume their normal daily activities. It may also allow them to undergo physical therapy to address an underlying cause of their pain. If you’re interested in learning more about facet joint injections, it may be time to talk to a pain specialist. You can find a pain doctor in your area by clicking the button below or looking for one in your area by using the tips here: https://paindoctor.com/pain-management-doctors/.

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