Signs your pain may involve the facet joints
Facet pain is often an ache on one or both sides of the spine that gets worse with twisting, leaning backward, or standing for long periods, and may be stiff in the morning. Imaging alone cannot always confirm it — that is where these injections help.
Two related procedures
Facet joint injection
A small amount of numbing medicine, often with a steroid, is placed directly into the joint using X-ray guidance. This can reduce inflammation and pain.
Medial branch block
The medial branch nerves carry pain signals from the facet joints. In a medial branch block, a small amount of numbing medicine is placed next to these nerves. This is mainly a diagnostic test: if your usual pain drops significantly for the next several hours, those nerves are likely involved, and radiofrequency ablation may offer longer-lasting relief.
After the procedure
- We may ask you to keep a simple pain diary for the hours after a diagnostic block — try doing activities that normally hurt and note how you feel.
- Mild soreness at the injection sites is common for a day or two.
- Most people return to normal activities the next day.
Preparing for your procedure
- Tell us about every medication you take, especially blood thinners (for example warfarin, apixaban, clopidogrel, or daily aspirin). Do not stop a blood thinner on your own — we will coordinate with the doctor who prescribes it.
- Let us know if you have diabetes, an allergy to contrast dye, iodine, latex, or local anesthetics, or if you may be pregnant.
- If you will receive sedation, plan on having an adult drive you home.
- Call us if you develop a fever or infection before your procedure date.
Risks
All procedures carry some risk. Depending on the treatment, possible risks can include soreness or bruising where the needle was placed, bleeding, infection, a temporary rise in pain, allergic reaction to a medication, and, rarely, nerve injury. If a steroid is used, some people notice short-term flushing, trouble sleeping, or higher blood sugar. Your provider will go over the specific risks, benefits, and alternatives for your situation before you decide.
Exercises you can do at home
Staying active is an important part of most pain treatment plans. See our low back (lumbar) exercises and neck (cervical) exercises for gentle stretches and strengthening options in lying, seated, and standing positions. Please ask your provider before starting, especially after a procedure.
This page is for general education and is not a substitute for an evaluation by a medical professional. Results vary, and no treatment works for everyone. Your provider will discuss whether this option is appropriate for you, along with its benefits, risks, and alternatives. Insurance coverage varies by plan — please call to verify.