What Can You Expect from a Facet Joint Injection? (2023)

A facet joint injection is a procedure where pain-relieving and anti-inflammatory medications are injected into your facet joints to reduce pain.

Your facet joints are a pair of small joints located at the back of your spine between each of your vertebrae. Wear and tear from years of use or traumatic injuries can sometimes cause pain in these joints.

Many people experience relief for months after receiving an injection. The procedure is minimally invasive and has a low risk of complications. Read on to learn more about these injections, including what they’re used to treat, their side effects, and the cost.

What Can You Expect from a Facet Joint Injection? (1)Share on Pinterest

Facet joint injections treat pain originating from the facet joints in your neck or back. According to 2021 research, it’s estimated that facet joint pain is the source of spine pain in up to:

  • 67 percent of people with neck pain
  • 48 percent of people with upper back pain
  • 45 percent of people with lower back pain

Facet joint injections contain medications called steroids that help reduce inflammation. They also contain lidocaine or other pain relievers.

Your doctor may recommend these injections if your pain does not respond to conservative treatment like physical therapy or modifying your activity levels for at least 3 months.

Potential causes of facet joint pain include:

  • osteoarthritis
  • joint instability
  • traumatic injury
  • impingement (excess pressure) of joint tissue
  • inflammation of joint lining

Facet joint injections are also used to help diagnose facet joint pain. A positive response to the injections suggests that the facet joint is the cause of pain.

(Video) Facet Joint Injections: What You Need To Know

Is facet joint injection the same as a nerve block or epidural?

No, these are all different but related procedures. If the medication is injected directly into your joint, the procedure is called an intra-articular facet joint injection or just a facet joint injection.

A facet joint nerve block is a similar procedure. It involves injecting medications near the branches of your medial nerves, which supply sensory information to your facet joints.

An epidural is a nerve block injected into the space surrounding your spinal cord to numb part of your body. It’s used during labor and some types of surgeries.

A facet joint injection is a minimally invasive procedure that usually takes less than 30 minutes. It’s an outpatient procedure, which means you can go home the same day. You’ll be awake during the procedure but may be offered sedation through an IV in your hand or arm.

Here’s an idea of what you can expect:

(Video) Lumbar Facet Joint Injection Procedure Animation

  1. During the procedure, you’ll lie face down on a table and may be connected to machines to monitor your vitals.
  2. Your skin will be sterilized around the injection site and covered with a drape to prevent contamination.
  3. Your surgeon will use a needle to inject a local anesthetic into your skin and numb the area.
  4. Using either fluoroscopy (a type of real-time X-ray) or a CT scan as a guide, your surgeon will insert the facet joint injection through your skin and into your joint. They may also inject a contrast dye to make sure the needle is in your joint.
  5. They will then inject the steroid and pain reliever into your joint.
  6. Finally, they’ll remove the needle and apply pressure to prevent bleeding. Stitches are not required.

How painful is a facet joint injection?

During the injection of local anesthesia, you may feel a pinch and some slight burning as it takes effect. However, it should not cause intense pain.

The facet joint injection itself should not cause any pain since the area will be numbed. You’ll likely feel some pressure around the injection site.

Once the pain reliever wears off, you may have soreness around the injection site for a few days. Your doctor may prescribe a pain reliever if you have significant pain.

Facet joint injections are generally safe, but all medical procedures come with some risks. The most common side effects are:

  • swelling
  • pain around the injection site
  • temporarily increased back pain

Rarely, the anti-inflammatory drugs used in the procedure may cause side effects such as:

  • warmth
  • fluid retention
  • weight gain
  • increased appetite
  • mood swings
  • irritability
  • anxiety
  • insomnia

Severe complications are very rare. In a 2020 study, researchers reported 101 complications across 11,980 procedures. Eight of these were considered major. All major complications were related to infection, and one person died of an infection.

Can facet injections make your pain worse?

A facet injection can lead to increased pain. This pain is usually temporary and related to swelling at the injection site.

It usually goes away once the medication has a chance to take effect. If the area around your injection is sore, you can try putting an ice pack on it for up to 20 minutes at a time.

Facet joint injections generally cost more than $1,000 in the United States. One surgery center in Texas lists their price as $1,276 to $1,458. The exact cost depends on factors such as:

  • the extent of your procedure
  • your geographic location
  • the clinic or hospital you visit

In a 2018 study, researchers estimated that the direct cost of a similar procedure, a facet joint nerve block, was $758.08. However, this does not cover the cost of drugs and medical therapy. The estimated total cost was 67 percent higher.

Are facet joint injections covered by insurance or Medicare?

According to the Medicare Coverage Database, facet joint injections may be covered if you meet the following requirements:

  • at least 3 months of moderate to severe pain with a functional impairment that has not responded to conservative treatments like nonsteroidal anti-inflammatory drugs or physical therapy
  • pain not associated with impinged nerves
  • absence of other non-facet conditions that could explain the pain
  • assessment by a medical professional that suggests your facet joints are the source of your pain

Other insurance providers may cover all or part of your procedure. It’s important that you check your plan in advance.

(Video) Facet Joint Injections

You may have some soreness around the site of the injection for a few days, so you’ll need to avoid strenuous activity and driving for the first 24 hours. You’ll likely be able to return to your regular activities the next day.

You may notice an increase in pain for several days after your procedure before the medication takes effect.

Facet joint injections can potentially offer relief for 3 months or longer. A 2018 review of studies found conflicting evidence on whether they offered pain relief between 3 to 6 months.

Facet joint injections can be repeated up to 3 times per year.

What’s the next step if facet joint injections do not work?

If your injection does not offer pain relief, it may be because the injection did not reach the source of pain or because your pain is not caused by your facet joints.

Your doctor can recommend what to do next. They may suggest trying a different injection or an alternative treatment like radiofrequency neurotomy, where heat is used to destroy the nerves that are causing pain.

(Video) Facet Injection - Dr. Sara Baird


(Video) Cervical facet joint injection procedure for neck pain

A facet joint injection reduces pain in the small joints at the back of your spine between your vertebrae. It’s a minimally invasive procedure that has the potential to reduce back or neck pain for months.

Your doctor can help you decide if a facet joint injection may be able to reduce your pain. They can also recommend alternative treatments to ease your symptoms.


How long does it take to recover from a facet joint injection? ›

Directly After Your Facet Joint Injections

After the injection, you may feel some immediate relief from your pain. However, this is not always the case. It is not uncommon for patients to experience some soreness and bruising at the injection site. This is normal and should resolve within a few days.

What can you not do after a facet joint injection? ›

Avoid heat to the injection area for 72 hours. No hot packs, saunas, or steam rooms during this time. A regular shower is OK. You may immediately restart your regular medication regimen, including pain medications, anti-inflammatories, and blood thinners.

What happens next after facet joint injections? ›

If facet joint injections do not alleviate your pain, there are other strategies that you and your doctor can explore to try to help your pain. These may include: Epidural injections (depending on where your pain is located) Additional testing, such as bone scans, bloodwork, or nerve studies.

Are there side effects from facet joint injections? ›

Commonly encountered side effects are increased pain from the injection (usually temporary), rarely inadvertent puncture of the “sack” containing spinal fluid (may cause headaches), infection, bleeding, nerve damage, or no relief from your usual pain.

Are facet joint injections worth it? ›

Facet joint injections tend to be a recommended treatment for pain caused by this inflammation. The injection works by reducing the inflammation. That not only reduces pain, but it also helps improve mobility.

What is the success rate of facet joint injections? ›

Facet joint injections are a mixture of fast-acting pain medication and slow-release cortisol. When a patient has been correctly diagnosed, and the right area is being treated, facet joint injections have a 75% success rate.

How painful is facet joint injections? ›

How painful is a facet joint injection? During the injection of local anesthesia, you may feel a pinch and some slight burning as it takes effect. However, it should not cause intense pain. The facet joint injection itself should not cause any pain since the area will be numbed.

Do facet joint injections help with stiffness? ›

While many conditions can lead to this type of pain and stiffness along your spine, your facet joints may play a role. If this is the case, facet joint injections provide the first line of defense against this type of back pain and neck pain.

Why is my back pain worse after facet joint injection? ›

Increased Pain

Sometimes, injections cause more pain. This may be due to increased spasm in the muscles around the injection. The increased pain is usually temporary, lasting a few hours or a few days. Once the medication has a chance to work, the injection may actually perform as expected and reduce your pain.

Are facet injections considered surgery? ›

Facet injections are considered as the most appropriate non-surgical means of treatment with minimal risks. The possible risks and complications associated with needle insertion may include bleeding, infection, allergic reaction or occasionally, damage to the nerves.

What is the difference between facet injections and epidural? ›

Although both treatments are utilized for pain relief, they're used for different underlying conditions. Epidural injections are for the back pain that radiates to the arm or legs. On the other hand, facet injections are injected into the facet joints for patients that suffer from degenerative conditions.

Is there a permanent solution to facet joint pain? ›

Facet joint syndrome cannot be reversed, but simple home therapies, as well as innovative non-surgical and surgical procedures, can help alleviate pain and improve a patient's quality of life.

Is it normal to have severe pain after facet joint injection? ›

Increased Pain

Sometimes, injections cause more pain. This may be due to increased spasm in the muscles around the injection. The increased pain is usually temporary, lasting a few hours or a few days. Once the medication has a chance to work, the injection may actually perform as expected and reduce your pain.

Is a facet joint injection considered surgery? ›

Facet joint injections are safe, non-surgical procedures that can provide long-term pain relief. Results vary between patients, but an effective joint treatments provides several months of pain relief.


1. What is a Facet Injection?
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