How Do I Know If I Need a Facet Joint Injection?
You should get a facet joint injection if you have persistent, sharp back and neck pain that worsens with twisting, bending, or standing for long periods. A facet joint injection also provides immediate relief in cases of radiating pain that isn’t improved with conservative treatment.
At Total Orthopedics and Sports Medicine, our fellowship-trained orthopedics perform physical exams and imaging tests, such as X-rays or CT scans, to locate the precise source of your pain. Before the facet joint injection procedure, we also use local anesthetic and steroid medication for minimal risk of adverse side effects. Book your appointment at 855-321-6784 to get this minimally invasive treatment.
When Do Doctors Recommend a Facet Joint Injection?
Doctors recommend facet injections when chronic pain in the lumbar, thoracic, or cervical region doesn’t improve with medications or other treatments. They also recommend these injections when pain worsens with extension or rotation, which may indicate inflammation in small joints due to facet joint arthritis, injury, or degeneration.
Moreover, here are some other situations in which healthcare providers recommend L4-L5 facet joint injection to provide long-term relief:
- Symptoms indicating facet joint syndrome or limited joint mobility.
- Inflammation in the small joints connecting vertebrae, common with aging or wear-and-tear.
- Disc problems increase stress on facet joints and cause inflammation.
- For persistent pain after spinal surgery, without nerve compression issues.
Who Is an Ideal Candidate For Facet Joint Injections?
You can get facet joint injections if you’re dealing with chronic back or neck pain that lasts longer than three months and remains localized along the spine. This injection is also ideal if the joint discomfort worsens with movements such as arching the back or twisting and does not improve with medications or other conservative treatments.
Additionally, people who experience stiffness, reduced mobility, and pain that isn’t radiating down the legs (sciatica) or arms (radiculopathy) can also receive this injection. However, before receiving these injections, you should assess potential complications, such as allergic reactions, to ensure it is the right choice for your condition.
How Does a Facet Joint Injection Provide Pain Relief?
A facet joint injection delivers targeted medication into the inflamed small joints of the spine to restore movement and provide immediate pain relief. The combined action of a local anesthetic and a steroid present in this injection helps reduce swelling and inflammation. Here’s how a facet joint injection works to relieve pain and locate the source of your symptoms:
1. Local Anesthetic
Local anesthesia, such as lidocaine or bupivacaine, quickly blocks pain signals from the spinal nerve as they prevent them from reaching the brain. This rapid response not only brings comfort but also helps confirm the facet joint as the actual source of the pain.
2. Corticosteroid
The corticosteroid works gradually to reduce inflammation in the joints, which eases irritation caused by arthritis or degeneration. This leads to significant relief and improved mobility, which can last from a few days to several weeks. Many people are able to resume normal activities once swelling decreases and the joint irritation settles.
3. Diagnostic Test
Other than providing significant relief, these injections also serve as an important diagnostic tool. If the injection delivers immediate pain relief, it confirms that the facet joint is the primary source of pain. But if symptoms remain unchanged, the cause of pain may be a herniated disc or a nerve-related issue within the epidural space. This clarity enables doctors to select the most suitable treatments, such as facet blocks or radiofrequency ablation, for achieving long-lasting relief.
How Many Facet Joint Injections Can You Safely Get In A Year?
You can typically get 3–4 facet joint injections per year for the same joint. Many specialists recommend no more than three in 12 months to stay safe and avoid steroid-related risks. This limit helps maintain long-lasting pain relief, protects cartilage, bone density, and the nervous system.
Moreover, the exact number of these injections also depends on your clinical outcome, overall health, and the effectiveness of these injections in reducing facet joint pain. While the recovery time is usually short, patients are advised to avoid strenuous activity or heavy lifting for a brief period.
When to see a doctor: Consult your healthcare provider if you experience any dural puncture or mood swings from steroids.
Are Facet Joint Injections Different From Epidural Steroid Injections?
Yes, facet joint injections target the small joints that cause joint pain, while epidural steroid injections focus on nerves inflamed inside the spinal canal. Although both injections reduce inflammation and provide pain relief, they serve different diagnostic and therapeutic purposes.
Additionally, facet joint injections are placed directly into the joint capsule to treat pain linked to arthritis, injury, or localized spinal irritation. In contrast, epidural steroid injections deliver medication around irritated spinal nerves to relieve radiating pain in legs or arms. While both are minimally invasive procedures, the choice depends on the underlying condition and the location of the pain (in a joint or nerve).
In fact, the NCBI systematic review found facet injections are valuable diagnostically but may offer only limited or short-term therapeutic relief for chronic low-back pain. On the other hand, epidural (transforaminal/caudal) injections are often chosen when nerve root irritation and radiating symptoms predominate.
What Factors Affect the Results of a Facet Joint Injection?
Facet joint injection success rate depends on patient-specific factors (age, obesity, uncontrolled diabetes, and nerve pain radiating down the limbs). It also depends on the underlying diagnosis (arthritis severity and the correct joint targeted), as well as procedural factors such as needle accuracy and medication dose/type.
Moreover, the following factors also impact the facet joint injection outcomes:
- Smoking and high BMI can increase inflammation or make the procedure difficult.
- Recent infections, bleeding disorders, or blood thinners may affect healing and safety.
- Allergies to anesthetics or contrast require alternative planning.
Accurate needle placement, the correct choice of steroid/anesthetic, and attentive post-procedure care also improve results. The NCBI study also shows that CT-guided facet joint injections expose patients to more than eight times higher radiation than procedures done with fluoroscopy.
How Long Does Pain Relief Last After A Facet Joint Injection?
Pain relief from a facet joint injection typically lasts from a few weeks to several months (often 3–6 months), depending on the severity of the inflammation and the individual’s response. Immediate relief from the local anesthetic lasts only hours, after which the steroid’s anti-inflammatory effects begin.
Besides this, the duration of relief also depends on the underlying condition, such as facet joint arthritis or chronic spinal degeneration. Moreover, targeted exercises, posture correction, and activity modification can also help extend the benefits of these injections. Some patients may also require repeat injections or additional treatments to maintain ongoing symptom control.
However, if you’re experiencing persistent back pain, leg pain, or stiffness that limits your daily movement, visit Total Orthopedics and Sports Medicine. We combine precise diagnostic injections, advanced imaging, and rehabilitation-focused care to reduce pain and restore mobility. Reach out today and let us help you return to an active lifestyle.
What Are the Risks or Side Effects of Facet Joint Injections?
Facet joint injections can cause side effects such as temporary pain, swelling, or bruising at the injection site, mild allergic reactions, and rarely infection or nerve irritation. If steroids are used, some patients may also experience temporary facial flushing, jitteriness, elevated blood sugar, or mood changes.
Moreover, in severe cases, nerve injury, hematoma, septic arthritis, or spinal cord irritation can occur, particularly in cervical (neck) injections. Also, a PubMed study of 43,000 facet joint nerve blocks revealed minor side effects, including local bleeding (76.3%), local hematoma (1.2%), Nerve root irritation, soreness, and vasovagal responses (<1%). Therefore, before the procedure, your doctor reviews your health history and medications (especially blood thinners) to reduce risk further and ensure the safest outcome.
Get Facet Joint Injections From Our Orthopedic Specialists at Total Orthopedics & Sports Medicine — Visit Us Now!
Persistent back or neck pain can severely limit your mobility, disrupt daily activities, and even affect your sleep. While facet joint injections are an effective treatment, they carry potential risks such as infection, bleeding, nerve irritation, and allergic reactions, which can worsen your condition if not properly managed.
At Total Orthopedics and Sports Medicine, we specialize in minimally invasive procedures like facet joint injections that reduce pain and improve your quality of life. Our team of experienced orthopedic specialists ensures each treatment is safe and performed with the highest standard of care. Schedule your consultation at 855-321-6784 or visit our office at 5500 Merrick Road, Massapequa, NY 11758 to achieve lasting pain relief.
FAQs
Can I Drive Or Work After A Facet Joint Injection?
No, you should avoid driving or performing work immediately after a facet joint injection. Mild sedation or numbness can affect your reflexes and coordination. Therefore, doctors advise patients to rest for the day and avoid strenuous activities. Your physician will also provide specific guidelines based on the medications used and your overall health.
Are Facet Joint Injections Covered By Insurance?
Yes, most health insurance plans often cover facet joint injections when doctors consider them medically necessary. Coverage typically depends on the diagnosis, prior conservative treatments, and the terms of your insurance policy. That’s why you should confirm with your insurance provider before scheduling the procedure to avoid unexpected expenses.
Can Facet Joint Pain Cause Nausea?
Yes, facet joint pain can indirectly cause nausea, especially if it’s severe or located in the neck (cervical spine). Intense pain triggers stress, and cervical issues can affect nerves controlling balance (cervical vertigo) or digestion (via the vagus nerve). Although rare in general facet pain, severe localized inflammation or pain radiating into the abdomen can also trigger nausea.
What Are The Indications For Facet Injections?
Doctors recommend facet injections for patients who experience facet-mediated pain in the neck/back caused by degenerative disc disease, spinal stenosis, or other issues. Moreover, these injections are also recommended when conservative treatments fail, pain disrupts daily life, or diagnosing facet joint involvement is necessary to guide further treatment options.
What Is The Alternative To Facet Joint Injection?
Alternatives to facet joint injections are oral medications like anti-inflammatories or muscle relaxants, radiofrequency ablation, and lifestyle modifications. In some cases, chiropractic care or acupuncture can also provide relief. However, choosing the right alternative depends on pain severity, overall health, and response to previous treatments.
Are Facet Joint Injections Safe For Older Adults?
Yes, facet joint injections are generally safe for older adults when performed by experienced specialists. When they’re injected precisely by using image guidance, such as fluoroscopy or computed tomography, patients experience faster results. Although age-related conditions may increase certain risks, doctors carefully assess overall health, medications, and complexities before proceeding.
Can Facet Joint Injections Reduce the Need For Surgery?
Yes, facet joint injections can reduce the need for surgery in many patients by providing targeted pain relief and improving function. They allow patients to engage in targeted exercises and daily activities with less discomfort. While these interventions are not a permanent solution, they often delay or eliminate the necessity for invasive surgical procedures.
