Facet joint injections

Facet joint injections are targeted treatments used to diagnose and relieve pain arising from the small joints at the back of the spine.

They are commonly used for back or neck pain where facet joints are suspected to be the source of symptoms, particularly when pain is localised or linked to movement.

AT A GLANCE

  • Targeted injections into the small joints of the spine
  • Used for back pain and neck pain
  • Can help confirm the source of pain
  • Often part of a wider treatment plan
  • Performed using imaging guidance for accuracy

Understanding facet joint injections

Targeted treatment for joint-related spinal pain

Facet joints are small joints located at the back of the spine that help guide movement and provide stability. Like other joints in the body, they can become inflamed, irritated or affected by wear and tear.

Facet joint injections are used to deliver medication directly into or around these joints to reduce inflammation and pain. They can also help confirm whether the facet joints are contributing to symptoms.

At Total Spine Health, these injections are used as part of a structured approach to diagnosis and treatment, helping guide further management where needed.

What are facet joint injections?

Targeting the joints at the back of the spine

Facet joint injections involve placing a small amount of local anaesthetic and anti-inflammatory medication into or around the facet joints.

The procedure is performed using imaging guidance to ensure accurate placement. If symptoms improve following the injection, this can help confirm that the facet joints are the source of pain.

In some cases, injections are used primarily for pain relief. In others, they form part of the diagnostic process before considering further treatments.

When this treatment may be used

Symptoms linked to facet joint pain

Facet joint pain often presents differently from nerve-related pain and is typically more localised.

  • localised pain in the neck or lower back
  • pain worse with movement, twisting or extension
  • stiffness, particularly after rest
  • pain not radiating far into the arm or leg
  • discomfort when standing for prolonged periods
  • pain that improves with rest or changes in position

Symptoms may develop gradually and are often linked to degenerative changes.

CONDITIONS TREATED

When facet joint injections may be appropriate

Facet joint injections are considered when joint-related pain is suspected based on symptoms, examination and imaging.

Facet joint pain

Inflammation or irritation of the facet joints causing localised spinal pain.

Degenerative spinal changes

Wear and tear affecting the joints can lead to stiffness and discomfort.

Mechanical back or neck pain

Pain related to movement and joint loading.

Postural strain

Prolonged or repetitive positions affecting joint function.

Persistent pain after injury

Joint irritation following strain or trauma.

Pain not responding to physiotherapy alone

When conservative treatment has not fully resolved symptoms.

Unclear pain source

Used diagnostically to help identify the cause of pain.

Combined spinal conditions

Facet joints contributing alongside other issues such as disc changes.

When facet joint injections may be considered

When targeted injections can help

Facet joint injections may be recommended when symptoms suggest joint-related pain and have not improved with initial treatment.

They are often used to both confirm diagnosis and provide relief.

  • persistent back or neck pain
  • pain linked to movement or posture
  • limited improvement with physiotherapy
  • uncertainty about the source of pain
  • imaging suggests facet joint involvement
  • symptoms affecting daily activity

ASSESSMENT AND SURGICAL PLANNING

Confirming the source of pain

Careful assessment is important to determine whether facet joints are contributing to symptoms.

  • review of symptoms and pain pattern
  • physical examination of spinal movement
  • imaging such as MRI or CT scan
  • correlation of findings with symptoms
  • discussion of expected outcomes
  • planning of targeted injection

The goal is to ensure injections are used appropriately and effectively.

PROCEDURES AND TECHNIQUES

How facet joint injections are performed

Facet joint injections are performed in a controlled clinical setting using imaging guidance for precision.

Fluoroscopy-guided injection

X-ray guidance is used to accurately place the needle into the joint.

Ultrasound-guided injection

In some cases, ultrasound may be used for guidance.

Intra-articular injection

Medication is injected directly into the facet joint.

Medial branch block

Injection around the small nerves supplying the facet joints.

Diagnostic injections

Used to confirm whether the facet joints are the source of pain.

Recovery after facet joint injections

What to expect after the procedure

Facet joint injections are usually performed as a day-case procedure, and most patients can return home shortly afterwards.

Some patients experience immediate relief from the local anaesthetic, followed by longer-term improvement as the anti-inflammatory medication takes effect.

  • return home the same day
  • gradual return to normal activity
  • temporary soreness at the injection site
  • monitoring of symptom improvement
  • follow-up to assess response
  • consideration of further treatment if needed

Relief may last weeks or months, depending on the underlying condition.

FAQs

Frequently asked questions about facet joint injections

Are facet joint injections painful?

Most patients tolerate the procedure well. Local anaesthetic is used to minimise discomfort.

How long do they take to work?

Initial relief may be felt quickly, with further improvement over several days.

How long does the effect last?

This varies. Some patients experience weeks or months of relief.

Are they used for diagnosis or treatment?

Both. They can help confirm the source of pain and provide symptom relief.

What happens if they don’t work?

If symptoms do not improve, other causes may be considered and alternative treatments discussed.

RELATED CONDITIONS

Conditions linked with minimally invasive surgery

RELATED TREATMENTS

Treatment pathways that may be relevant