Facet Joint Injections
A facet joint injection delivers corticosteroid and local anesthetic directly into an arthritic spinal joint, reducing inflammation and pain.
Facet arthritis is a common source of localized back and neck pain. These injections are used when conservative treatment alone has not provided sufficient relief.
What this treatment is and why it is used.
The facet joints are small joints that run along both sides of the spine, allowing it to bend and twist. When cartilage inside these joints breaks down (facet arthritis), the result can be localized back pain, neck stiffness, or referred pain in the shoulder, buttock, or upper leg. Unlike herniated disc pain, facet pain is typically worse with backward bending and side-bending of the spine.
A facet joint injection targets inflammation inside the joint capsule itself by delivering a corticosteroid directly into the joint space. This is distinct from a medial branch block, which numbs the small nerves that supply the joint and is often used as a diagnostic test before radiofrequency ablation. Both procedures are performed under fluoroscopic guidance, but they address different anatomical targets.
At our clinic, every facet injection is performed under live X-ray to confirm needle tip placement inside the joint before medication is delivered. We take time to position the needle accurately, assess your response, and integrate the injection with a plan for activity and rehabilitation.
Our team starts with a clinical evaluation to confirm the pain generator before any procedure.
The procedure, step by step.
Every step is designed for accuracy and comfort. You will know what to expect before, during, and after.
Your physician determines which facet joint (or joints) is causing pain based on your symptom pattern, physical exam, and imaging.
You lie face down on the fluoroscopy table. The skin over the target facet joint is cleaned and draped sterilely.
Numbing medication is applied to the skin and deeper tissue along the needle path to the joint.
Live X-ray guidance is used to advance a thin needle to the facet joint. Contrast dye confirms the needle is inside the joint capsule.
A small volume of corticosteroid and local anesthetic is injected into the joint space. You may feel mild pressure during the injection.
The needle is removed, the area is dressed, and you rest briefly in recovery before discharge with aftercare instructions.
Before, during, and after the appointment.
You will receive pre-procedure instructions about medications to pause, fasting if sedation is planned, and arrival timing. Bring a driver if sedation will be used. Tell us about blood thinners, anticoagulants, or recent infections.
You lie face down and the skin is numbed. Using live X-ray, the physician carefully positions the needle into the facet joint. The injection is brief; most patients experience mild pressure rather than severe pain.
You rest in recovery. The local anesthetic provides immediate but temporary relief; the steroid's benefit develops over several days. Mild soreness at the injection site is normal.
What recovery typically looks like.
Most patients return to light activity the next day. We recommend avoiding heavy lifting, strenuous exercise, and prolonged spinal bending for 24–48 hours. Once initial soreness settles, resuming your physical therapy or structured movement program helps maximize the benefit of the injection.
Candidacy is determined after a clinical evaluation.
Facet joint injections are performed routinely at specialized pain clinics and are well tolerated when performed by experienced practitioners under fluoroscopic guidance. Candidacy depends on your clinical presentation, imaging findings, prior treatments, current medications, and overall health. We will evaluate you thoroughly before scheduling to ensure this procedure is appropriate for your condition.
Medicare and major insurance accepted.
Facet joint injections are covered by Medicare and most major commercial insurance plans when medically appropriate. Our staff verifies your insurance benefits in advance, coordinates any required prior authorization, and reviews your expected out-of-pocket costs before the procedure.
See accepted insurance plansCommon pain patterns we pair with facet joint injections.
Procedures that often work alongside this one.
Questions patients ask about this procedure.
How is a facet injection different from a medial branch block?
A facet joint injection places steroid and anesthetic directly into the joint space to reduce inflammation inside the joint. A medial branch block numbs the small nerves that supply the joint and is typically used as a diagnostic test before considering radiofrequency ablation. Both are useful depending on your condition and goals.
How long does relief last?
Duration varies. Some patients experience relief lasting weeks to several months. Combining the injection with physical therapy, activity modification, and ongoing self-management typically produces the longest-lasting results.
What if one injection is not enough?
We reassess your response at 2–4 weeks. Repeat injections are spaced per clinical guidelines based on your individual response and goals. The aim is to use the fewest injections needed to support meaningful rehabilitation and activity.
Will I need sedation?
No. Facet injections are performed with local anesthesia only. Some patients choose mild sedation for comfort, but it is not required. We discuss your preference during your consultation.
Talk to a board-certified pain specialist.
We see new patients by referral across our Pasadena, Baytown, and Katy clinics. Our team will verify your insurance and walk you through the next step.
- Board-certified, fellowship-trained physician
- Medicare and major insurance accepted
- Three Greater Houston locations
- Bilingual staff and direct phone access
Request a facet joint injections consultation
Steroid placed directly into an arthritic facet joint of the spine to calm the inflammation driving axial back or neck pain.