Facet Joint Injection: What It Is and What to Expect
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor provides Facet Joint Injection?
A pain physician, a doctor who treats long-lasting pain, usually performs a facet joint injection. Doctors from several specialties perform spine procedures like this one. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What it is
Facet joints are joints between neighboring bones of the spine. A facet joint injection puts medicine, such as a steroid, into a facet joint. A diagnostic block uses a local anesthetic to help find out if a joint is causing the pain. The steps below describe injections in the low back (lumbar spine). Recovery and risks describe steroid joint injections in general.
Why a doctor might recommend it
Facet joints are considered one of the most common causes of low back pain. Facet joint pain is more common in older people. Pain from these joints is mostly felt in the low back, buttocks, and thighs. Pain features, physical findings, and imaging cannot confirm facet joint pain on their own. Doctors recommend these injections for people who may have facet joint pain. Common reasons include the following.
- Low back pain that causes trouble with daily function
- Pain in the low back and legs that has lasted at least three months
- Other care, such as physical therapy, chiropractic care, and medicine, has not helped
How to prepare
A joint steroid shot is usually done in your provider's office. Your provider will tell you what preparation is needed, but usually there is none.
What happens during it
A pillow can be placed under your belly to make it easier to reach the joint. The skin is cleaned, and a numbing medicine may be applied. The doctor uses fluoroscopy, a type of X-ray, to see the joint and guide the needle. The doctor stops moving the needle forward once it enters the joint. This avoids damaging the cartilage. A small amount of steroid and local anesthetic is then injected into the joint. The procedure typically takes 15 to 30 minutes, and you can go home the same day.
Recovery
You may notice less pain for the first few hours because of the numbing medicine. After it wears off, the pain you had before may return and last several days. The steroid usually starts to work 5 to 7 days after the injection. You might have slight swelling and redness around the injection site. If you have swelling, wrap an ice pack in a cloth and use it for 15 to 20 minutes, 2 to 3 times per day. Avoid a lot of activity the day you get the shot. If you have diabetes, the steroid can raise your blood sugar level, most often only by a small amount.
Risks and side effects
A clinical review calls complications from these injections in the low back rare. The most common problems are swelling, pain where the needle goes in, and low back pain. These are known to be short-lived. Risks of a steroid injection may include the following.
- Pain and bruising at the injection site
- Skin irritation and color changes at the injection site
- Allergic reaction to the medicine
- Infection
- Bleeding in the joint
- Damage to nerves near the joint
Contact your provider if pain, redness, swelling, or fever gets worse after the injection. Call 911 or go to the emergency room if you have trouble breathing, chest pain or discomfort lasting two minutes or more, fainting, bleeding that will not stop, swelling of the face, eyes, or tongue, or sudden dizziness, weakness, or change in vision.
Who performs it
A pain physician usually performs a facet joint injection. Pain physicians need a detailed understanding of the spine to do these procedures safely.
Common questions
Do facet joint injections work?
The clinical evidence that facet joint injections relieve pain is considered limited. A clinical review says diagnostic blocks with numbing medicine are the only reliable way to confirm that a joint causes the pain.
How long does a facet joint injection take?
The procedure typically takes 15 to 30 minutes. You can go home the same day.
When does a facet joint injection start to work?
The steroid usually starts to work 5 to 7 days after the injection. The numbing medicine lessens pain for the first few hours, and then wears off.
How does a direct primary care or concierge doctor fit in?
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance.
Sources
- National Library of Medicine (PubMed Central) - Facet joint injections for management of low back pain: a clinically focused review
- MedlinePlus - Steroid injections - tendon, bursa, joint
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
