Facet Injections
Procedures
What Are Facet Injections?
Facet injections are minimally invasive, targeted procedures in which a mixture of corticosteroid (to reduce inflammation) and anesthetic (for temporary pain relief) is injected directly into the facet joints. These small joints, located between each vertebra, stabilize the spine and allow controlled movement.
When irritated or degenerated by arthritis, injury, or wear-and-tear, facet joints can cause chronic back or neck pain. Injections serve both a diagnostic purpose (confirming the facet joint as the pain source) and a therapeutic role (providing pain relief).
Conditions Treated with Facet Injections
- Facet joint syndrome: Inflammation or arthritis in the spinal joints.
- Chronic neck, mid-back, or low back pain.
- Pain worsened by extension, rotation, or bending.
- Spondylosis (degenerative spine changes).
- Whiplash or minor trauma-related pain (in some cases).
Who Is a Good Candidate?
- Patients with persistent, localized back or neck pain not relieved by medications, therapy, or chiropractic care.
- Those whose pain is worsened by spinal extension, rotation, or direct pressure over facet joints.
- Patients needing diagnostic clarity about their pain generator.
- Not ideal for patients with:
- Active infection.
- Bleeding disorders or uncontrolled anticoagulation.
- Allergy to contrast dye or steroid medication.
Types of Pain Treated
- Deep, aching pain in the back, neck, or mid-spine.
- Localized or referred pain (but not usually radiating down arms or legs like sciatica).
- Pain that flares with specific movements such as arching, twisting, or prolonged standing.
What to Expect
Prior to the Procedure
- Review of symptoms, medical history, and imaging (MRI, CT, or X-ray).
- Stopping certain medications (like blood thinners) may be recommended.
- Clear explanation of the diagnostic vs. therapeutic goals.
During the Procedure
- Outpatient procedure using sterile technique.
- Local anesthetic applied for comfort.
- Fluoroscopic (X-ray) or ultrasound guidance ensures accurate needle placement into the facet joint.
- Small amount of anesthetic + steroid injected.
- Procedure usually takes less than 20 minutes.
After the Procedure
- Mild soreness at injection site for 24–48 hours.
- Resume most normal daily activities within a day.
- Track pain relief over hours to days—important for diagnostic interpretation.
Benefits of Fluoroscopy
- Precise medication delivery directly into the facet joint.
- Accurate diagnosis of pain origin.
- Improved safety, avoiding nearby nerves and blood vessels.
Expected Outcomes from Facet Injections
- Rapid pain relief, often within days.
- Relief lasting weeks to several months, depending on individual response.
- If injections are effective, radiofrequency ablation (RFA) can be considered for longer-lasting results (6–18 months).
- Improved ability to participate in rehabilitation and strengthening programs.
Important Considerations
Facet injections are generally safe, but risks include:
- Temporary soreness or increased pain.
- Infection (rare).
- Bleeding or hematoma at the injection site.
- Allergic reaction to anesthetic, steroid, or contrast dye.
- Temporary numbness or weakness in nearby muscles.
Alternatives & Complementary Treatments
- Medications: NSAIDs, muscle relaxants, or neuropathic agents.
- Physical Therapy: Core strengthening, posture retraining, mobility work.
- Chiropractic/manual therapy: Gentle joint mobilization.
- Lifestyle changes: Weight management, ergonomics, anti-inflammatory nutrition.
- Radiofrequency ablation: For long-term relief if diagnostic injections confirm facet pain.
Clinical Research
Studies show that facet injections:
- Are effective in diagnosing facet-mediated pain.
- Provide significant relief for selected patients, especially when combined with rehabilitation and anti-inflammatory care.
- Are safe when performed under imaging guidance, with minimal complication rates.
Integrative Care at Holistiq Spine & Orthopaedic
Holistiq utilizes a multidisciplinary, non-surgical approach for chronic MSK conditions. We combine ESIs with:
Peripheral magnetic stimulation
Chiropractic and manual therapy
Movement restoration and rehabilitation
For patients who require surgery, Holistiq coordinates with top surgeons and supports optimal pre- and post-op recovery using our integrative system.
Epidural steroid injections are one tool in a suite of evidence-based options to relieve MSK pain, restore function, and help you return to a better quality of life.
FAQs
How long does pain relief last?
Relief can last anywhere from a few weeks to several months. Results vary based on the degree of degeneration and inflammation.
How many injections can I have?
Typically limited to a few per year at the same site to avoid tissue weakening.
Do facet injections treat sciatica or nerve pain?
Not usually—they target joint-related pain, not nerve compression.
Is radiofrequency ablation better?
If injections provide short-term relief, RFA may be the next step for longer-lasting results.
What’s the difference between a facet injection and an epidural steroid injection?
Facet injections target the small joints of the spine to address joint-related pain, while epidural injections deliver medication around the spinal nerves to relieve nerve compression pain (such as sciatica).
Are facet injections covered by insurance?
Most insurance providers cover them when conservative treatments have failed and medical necessity is documented, though coverage can vary.
What happens if the injection doesn’t work?
If you don’t get meaningful relief, it suggests your pain may not be facet-related. In that case, your provider will reassess and may recommend alternative diagnostics or treatments.
Why Choose Holistiq Spine & Orthopaedic?
At Holistiq, facet injections are not a stand-alone fix—they’re part of a comprehensive spine care program. We integrate:
- Interventional pain procedures with imaging guidance.
- Anti-inflammatory nutrition plans to support healing.
- Manual therapy and rehab to restore function and stability.
- Collaboration with surgeons when needed for complex cases.
Where Does It Hurt? We Can Help.
Procedures
