Facet Joint Injections

What are facet joints?

 

Facet joints are small paired joints that connect the bones of the spine.

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They help the spine:

• Bend

• Twist

• Extend

• Maintain stability

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Like any other joint, facet joints can become painful due to:

• Osteoarthritis

• Injury

• Repetitive strain

• Age-related wear and tear

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They are a common cause of persistent neck and low back pain.

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What is a facet joint injection?

 

A facet joint injection involves placing a small amount of local anaesthetic and corticosteroid directly into the painful facet joint using X-ray guidance.

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The local anaesthetic provides temporary pain relief, while the steroid aims to reduce inflammation around the joint.

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The procedure is performed as a day-case under local anaesthetic.

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Who may benefit?

 

Facet joint injections may be considered for patients with:

• Persistent neck pain

• Persistent low back pain

• Suspected facet joint arthritis

• Pain worse when standing or leaning backwards

• Pain that has not improved with physiotherapy or medication

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Not every patient with spinal pain will benefit from facet joint injections, and careful assessment is important.

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How do we determine whether I'm suitable?

 

Before recommending treatment, I assess:

• Your symptoms

• Physical examination findings

• Previous imaging

• Other possible causes of pain

• Your response to previous treatments

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The aim is to identify whether the facet joints are the most likely source of your pain.

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What happens during the procedure?

 

Facet joint injections are usually completed in 20–30 minutes.

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The procedure involves:

1. Positioning you comfortably on the X-ray table.

2. Cleaning the skin and applying local anaesthetic.

3. Using X-ray guidance to identify the affected facet joints.

4. Placing a fine needle into the joint.

5. Injecting local anaesthetic and corticosteroid.

6. Applying a small dressing before discharge.

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Most patients return home shortly afterwards.

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Recovery

 

Most people experience only mild soreness around the injection site for a day or two.

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You can usually:

• Walk immediately afterwards

• Resume light activities the following day

• Return to normal activities over several days

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The local anaesthetic may provide temporary relief immediately after the procedure. The steroid, if effective, usually begins to work over several days.

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What are the benefits?

 

For carefully selected patients, facet joint injections may:

• Reduce pain

• Improve movement

• Reduce inflammation

• Improve sleep

• Support physiotherapy and rehabilitation

• Help identify whether the facet joints are contributing to your symptoms

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The amount and duration of pain relief varies between individuals.

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How do facet joint injections differ from medial branch blocks?

 

Although the names are sometimes used interchangeably, they are different procedures.

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A facet joint injection places medication directly into the joint and is primarily used to reduce inflammation and provide pain relief.

A medial branch block places local anaesthetic around the small nerves supplying the facet joints. It is commonly used to help determine whether radiofrequency ablation is likely to be beneficial.

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During your consultation, we will discuss which procedure is most appropriate for your symptoms.

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What if the pain returns?

 

If pain returns after successful treatment, there are several possible options.

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Depending on the diagnosis, these may include:

• Repeat injections

• Physiotherapy

• Medication optimisation

• Medial branch blocks

• Radiofrequency ablation

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Treatment is always tailored to your individual circumstances.

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What are the risks?

 

Facet joint injections are generally considered very safe when performed under image guidance.

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Possible risks include:

• Temporary soreness

• Bruising

• Bleeding

• Infection

• Temporary increase in pain

• Steroid-related side effects such as facial flushing or temporary changes in blood sugar

• Failure to improve symptoms

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Serious complications are uncommon.

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Frequently Asked Questions

 

Will a facet joint injection cure my arthritis?

 

No.

The injection does not reverse arthritis but may reduce pain and inflammation, allowing you to move more comfortably.

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How long do facet joint injections last?

 

Relief varies between individuals. Some patients experience benefit for weeks or months, while others may experience only temporary improvement.

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Are facet joint injections painful?

 

Most patients tolerate the procedure well. Local anaesthetic is used to numb the skin before the injection.

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Will I need more than one injection?

 

Not necessarily.

Some patients achieve satisfactory relief with a single treatment, while others may require additional treatment depending on their response.

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What's the difference between facet joint injections and radiofrequency ablation?

 

Facet joint injections aim to reduce inflammation within the joint. Radiofrequency ablation interrupts pain signals from the nerves supplying the joint and may provide longer-lasting relief for carefully selected patients.

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Can I drive home afterwards?

 

This depends on the area treated and the medications used. You should discuss this before your appointment and arrange transport if advised.

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Why choose Dr David Crabtree?

 

As a Consultant in Pain Medicine, I specialise in diagnosing and treating persistent spinal pain. My approach is to identify the most likely cause of your symptoms before recommending any intervention.

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All spinal injections are performed under X-ray guidance to maximise precision and safety. Where injections are unlikely to provide lasting benefit, I will discuss alternative treatments that may be more appropriate.

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Ready to explore your treatment options?

 

If persistent neck or back pain is affecting your quality of life despite physiotherapy or medication, a consultation can help determine whether facet joint injections—or another treatment—are the most appropriate next step.

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