What is a facet joint injection?
Facet joints are small, paired joints along the back of the spine that guide motion and can become painful from arthritis, injury, or degeneration. A facet joint injection places a small amount of numbing medicine and a corticosteroid into or around the affected facet joint to both diagnose and treat pain. The procedure is performed using live X-ray guidance (fluoroscopy) to confirm precise needle placement, often with a small amount of contrast dye.
Conditions facet injections may help
- Facet arthropathy/arthritis
- Mechanical low back or neck pain aggravated by extension or rotation
- Pain after whiplash or repetitive overuse
- Pain from degenerative changes or post-surgical syndromes
Facet injections can be used therapeutically to calm inflamed joints and diagnostically to confirm the facet joint as a pain source (often guiding next-step treatments such as radiofrequency ablation).
How the procedure works at Summit Spine
- Check-in & prep – You’ll review your history and medications; some patients may be asked to pause blood thinners per physician guidance.
- Imaging guidance – Under fluoroscopy, your physician advances a fine needle to the facet joint. Contrast confirms position
- Medication delivery – A small amount of local anesthetic and steroid is placed into or around the joint.
- Observation & discharge – You’ll rest briefly, then head home with post-procedure instructions. Many people can resume light activity the next day. (Timelines can vary—your provider will advise.)
What to expect after a facet injection
- Immediate numbness from the anesthetic may give short-term relief; steroid effects typically build over 3–5 days.
- Relief duration varies—from hours to months—depending on the underlying condition, activity level, and overall care plan.
- If you get significant short-term relief from a medial branch block (a closely related diagnostic injection targeting the facet nerve), you may be a candidate for radiofrequency ablation (RFA) for longer-lasting relief.
Benefits
- Minimally invasive, clinic-based procedure
- Image-guided accuracy for safety and effectiveness
- Can reduce pain and inflammation to support physical therapy and activity
- Helps pinpoint whether the facet joint is your primary pain generator
Risks & safety
Facet injections are generally low-risk. As with any needle procedure, there is a small risk of bleeding or infection; providers use sterile technique and imaging to minimize risks. Your physician will review your specific situation, including medications and medical conditions.
Who is a good candidate?
You may be considered for facet injections if you have:
- Persistent axial neck or low-back pain that worsens with extension/rotation
- Tenderness over facet joints on exam and imaging findings consistent with facet arthropathy
- Limited response to conservative measures (activity modification, anti-inflammatories, PT)
- Prior surgery with ongoing facet-mediated pain
Your Summit provider will tailor a plan that may include PT, medications, image-guided injections, and—if appropriate—advanced options like RFA or neuromodulation.
FAQs
Will I need a driver?
Many patients do, especially if a sedative is used or per clinic policy; confirm when scheduling. Plan to take it easy the day of your procedure. Emory Healthcare
How many injections can I have?
Your provider follows evidence-based guidelines and your insurer’s medical-necessity criteria to determine timing and frequency. (Injections are one part of a broader plan that may include PT and, when indicated, RFA.
How quickly will I feel better?
Some feel immediate numbness relief that fades as the anesthetic wears off; steroid effects usually build over several days, with total duration varying per person.