What is a Facet Joint Injection?
Facet joints are small paired joints connecting the vertebrae of the spine, present at every level from the neck down to the lower back. They give the spine its stability and allow for the range of motion used every day, bending, twisting, and turning. Like any joint in the body, they are subject to wear over time. When they become inflamed or arthritic, the resulting pain can be significant and, for many people, surprisingly hard to trace to a single source.
A facet joint injection is a minimally invasive procedure that delivers a corticosteroid and a local anesthetic directly into or around an affected facet joint. The corticosteroid reduces inflammation within the joint, while the local anesthetic provides more immediate pain relief. Used together, they can calm an irritated facet joint that has not responded to conservative care, offering relief that can last anywhere from several weeks to several months depending on the underlying condition and how the joint responds.
What makes facet joint injections particularly valuable is their dual purpose. In addition to providing therapeutic relief, the injection serves as one of the most reliable diagnostic tools available for confirming whether a specific facet joint is the true source of pain. When a targeted injection produces meaningful improvement, it confirms the diagnosis and provides a clear direction for the next phase of care, whether that is a repeat injection or a longer-lasting solution such as radiofrequency ablation. When it does not produce improvement, it helps rule out the facet joint and redirects the diagnostic focus elsewhere.
Facet joints exist at every level of the spine, which means facet joint injections can be performed in the cervical, thoracic, or lumbar region depending on where symptoms are originating. At Shore Spine & Pain in Lakewood and Shrewsbury, NJ, Dr. Woska performs facet joint injections as part of a broader, diagnosis-driven approach to spinal pain. If you are experiencing chronic neck or back pain and have not yet found a clear answer about what is causing it, contact us today to schedule a consultation.
Why is a Facet Joint Injection Performed?
Facet joint pain does not always announce itself in obvious ways, which is part of what makes it so frequently misattributed. The pain can be localized to the spine itself or spread into the shoulders, arms, buttocks, or thighs depending on which level is involved. It tends to worsen with specific movements and positions rather than being constant, and that variability is part of what makes an accurate diagnosis so important before treatment begins.
Dr. Woska recommends facet joint injections at Shore Spine & Pain when one or more of the following is present:
- Chronic neck or back pain that has not responded adequately to conservative care including medications and activity modification
- Pain that worsens with spinal extension, prolonged sitting, or rising from a seated position
- Imaging findings consistent with facet joint syndrome, degeneration, or osteoarthritis
- Radiating pain into the arms, shoulders, buttocks, or thighs without a clear disc or nerve root explanation, such as that seen with a herniated disc or sciatica
- A need to confirm whether the facet joints are the primary pain source before proceeding with a longer-term treatment such as radiofrequency ablation
A facet joint injection is not only a treatment; it is also one of the most reliable ways to answer the diagnostic question of whether a specific joint is responsible for your pain. A meaningful reduction in symptoms following the injection confirms the source and provides a clear direction for what comes next.
How is a Facet Joint Injection Performed?
At Shore Spine & Pain, every facet joint injection begins well before the day of the procedure. Dr. Woska reviews your imaging, symptom history, and medical background in advance to confirm that a facet joint injection is the right approach for your specific situation and to identify precisely which joint or joints will be targeted.
On the day of your appointment, you will be made comfortable on a procedure table, typically face down, to give Dr. Woska clear access to the area being treated. The skin is cleaned and a local anesthetic is applied to the treatment site, so most people find the procedure considerably more comfortable than they expected going in.
Throughout the injection, Dr. Woska uses fluoroscopy, live X-ray imaging, to monitor needle placement in real time. This continuous imaging is what separates a precisely guided injection from one performed on estimation alone. As the needle approaches the target joint, a small amount of contrast dye is introduced before any medication is delivered. That dye spreads through the joint space and appears clearly on the fluoroscope, providing visual confirmation that the needle is exactly where it needs to be. Only after that confirmation does Dr. Woska deliver the therapeutic solution, a corticosteroid to reduce inflammation within the joint and a local anesthetic for more immediate relief.
From start to finish, the injection itself takes only a few minutes. Most people describe feeling mild pressure at most, and are ready to leave the clinic shortly after the procedure is complete.
What To Expect After a Facet Joint Injection
Following your facet joint injection at Shore Spine & Pain, you will rest briefly while the team monitors you before heading home the same day. Arranging for someone to drive you is recommended, as the local anesthetic can cause temporary effects that make driving inadvisable immediately after the procedure.
Some people notice relief relatively quickly due to the anesthetic component, though that effect is temporary and fades within hours as the medication wears off. The corticosteroid takes longer to build. Most people begin to notice meaningful improvement within a few days to a week, with the full effect often developing over one to two weeks. At Shore Spine & Pain, Dr. Woska tracks your response carefully during this period, because how your pain responds to the injection is clinically important information, not just for managing your current symptoms but for determining the most effective path forward.
How long relief lasts varies from person to person and depends largely on the underlying condition. Some experience significant improvement for several months. Others may benefit from a follow-up injection, while a strong positive response may point toward a longer-lasting solution such as radiofrequency ablation or, in cases of significant joint deterioration, facet joint fusion. Keeping track of your pain levels in the days following the procedure will help Dr. Woska build an accurate picture at your follow-up appointment at Shore Spine & Pain in Lakewood or Shrewsbury, NJ and make the most informed decisions about what comes next for your care.
Frequently Asked Questions about Facet Joint Injections
How do I know if a facet joint injection is right for me?
A good candidate is typically someone dealing with chronic neck or back pain that has not responded well to medications or other conservative care, and whose imaging or physical examination suggests facet joint syndrome may be the underlying cause. Conditions such as degenerative disc disease and spondylolisthesis frequently involve facet joint degeneration as a contributing factor, making this procedure relevant to a broader range of spinal conditions than many people realize. The best way to find out is through a consultation with Dr. Woska at Shore Spine & Pain in Lakewood or Shrewsbury, NJ, where your history and symptoms can be reviewed in full.
How long does it take to feel relief?
The local anesthetic in the injection may produce some immediate relief, but that typically fades within hours as it wears off. The corticosteroid, which does the heavier work of reducing inflammation, generally takes a few days to begin working. Most people notice meaningful improvement within one to two weeks. Keeping a simple log of your pain levels during that window will help Dr. Woska assess how well the injection worked at your follow-up appointment at Shore Spine & Pain.
How long will the relief last?
It varies considerably from person to person and depends on the underlying condition being treated. Some people experience relief for several months. Others benefit from a follow-up injection to maintain the improvement. The response itself is also diagnostically valuable: if the injection brings significant relief, it helps Dr. Woska confirm the facet joint as the source of pain and opens the door to longer-lasting options such as radiofrequency ablation.
How many injections will I need?
Dr. Woska will not commit to a fixed number upfront because the right answer depends on how you respond. Some people do well after a single injection. Others benefit from a series spaced over time. That conversation happens at your follow-up appointment at Shore Spine & Pain based on real feedback from your recovery rather than a predetermined schedule.
Is there anything I need to do to prepare?
Dr. Woska will provide specific instructions based on your health history before your appointment at Shore Spine & Pain. In general, arranging a ride home is important since driving after the procedure is not recommended. You may be asked to temporarily pause certain medications, particularly blood thinners, in the days leading up to the injection. Wearing comfortable clothing and eating a light meal beforehand is usually fine unless Dr. Woska has advised otherwise.
