Facet injections deliver a corticosteroid and/or local anesthetic into or alongside a facet joint suspected of being the source of back pain. They can confirm the diagnosis and provide weeks to months of relief. For longer relief, rhizotomy may follow.
What the injection does
A facet injection places medication — usually a long-acting corticosteroid combined with a local anesthetic — into or alongside a facet joint suspected of generating pain. The combination quiets local inflammation and temporarily numbs the small nerves carrying pain signal from the joint.The diagnostic information is often as valuable as the therapeutic effect. If a targeted injection at a specific level reliably reduces the patient’s pain, that level is implicated. If it doesn’t, the source is somewhere else.
How it's done
The procedure is performed under image guidance — fluoroscopy or ultrasound — to ensure the needle is in the right position. Local anesthesia at the skin and along the needle path keeps the procedure comfortable. The injection itself takes only a few minutes per level; total time including setup and brief observation is typically under an hour.No general anesthesia is needed. Most patients drive themselves home or return to normal activity within a few hours.
When the relief is meaningful
For patients whose pain is genuinely facet-mediated, the relief from a corticosteroid injection can last weeks to a few months. Some patients experience repeated benefit from periodic injections. Others benefit from a transition to rhizotomy for more durable relief.For patients whose pain comes primarily from another source — a herniation, stenosis, diffuse degeneration — the injection may produce little or no benefit, which itself is useful information.
Send your MRI for a free review
Dr. McMillan reviews each scan personally. You get a candid answer about candidacy before any travel or scheduling.
What we suggest doing first
If you are weighing this decision, the most useful single action is sending your MRI for a free review. The review costs nothing and produces a candid written assessment from Dr. McMillan — including the answer that you are not a candidate, when that is the honest answer. We do not ask patients to travel for a procedure that will not help them.
When the review indicates that the endoscopic approach fits, the next step is a $250 consultation. The fee covers Dr. McMillan’s time to review the imaging in detail and discuss what the procedure would involve for your specific situation. If you decide to proceed, the $250 is credited toward the procedure bundle. If you decide not to proceed, you owe the consultation fee and nothing further.
From there, scheduling moves at a pace that fits your situation. The procedure is outpatient, takes about an hour, and most patients are home the same day. Post-procedure follow-up is part of the bundle. For patients coming from out of town, the office coordinates lodging guidance, transportation considerations, and handoff with your local providers — this is a routine part of how we work, not an exception. The goal throughout is to make a complicated decision more navigable, with the actual numbers and the actual options in front of you.
How it fits the larger plan
Facet injections are one element of a multi-pronged approach to chronic back pain. They are most valuable when used purposefully — for diagnostic confirmation or as part of a planned treatment ladder — rather than as a default response to back pain of any kind. The honest answer is sometimes that injections won’t help; identifying that early saves the patient unnecessary procedures.Bottom line
Facet injections deliver a corticosteroid and/or local anesthetic into or alongside a facet joint suspected of being the source of back pain. They can confirm the diagnosis and provide weeks to months of relief. For longer relief, rhizotomy may follow.
If you’ve been told you need a fusion — or you’re trying to avoid one — a free MRI review is the most useful next step. Dr. McMillan reviews each scan personally and tells you candidly whether the endoscopic approach fits your specific anatomy.
For patients dealing with spinal facet injections, the conversation comes down to specifics: what your imaging actually shows, what your symptoms are actually telling us, and which procedure (if any) genuinely matches that pattern. The candid answer is sometimes that you do not need surgery yet; the candid answer is sometimes that you do, but a smaller operation than the one you have been quoted. A second-opinion MRI review separates those cases and gives you the information you need to make the decision well.
The Synergy approach to facet joint injections
At Synergy Spine Center, facet joint injections is performed by Dr. Marion McMillan personally — the same surgeon who reviews your imaging, plans the operation, and handles your post-operative care. This single-surgeon model isn’t unusual for boutique surgical practices; it’s structural at Synergy because the spine literature shows volume-outcome relationships for individual operators. Patients pursuing this procedure most often arrive with a diagnosis of facet joint syndrome or spinal facet arthritis after being told elsewhere that more invasive surgery — typically fusion — is their only path forward.
Candidacy is established before any travel commitment through the free MRI review process. Patients submit recent imaging and a brief clinical history; the review identifies whether the specific pathology shown on imaging would respond to facet joint injections or whether a different intervention would be more appropriate. If you’re a candidate, you’ll receive a written assessment along with transparent bundled pricing for the procedure. If you’re not a candidate, you’ll be told that directly, often with a referral to the appropriate specialty — the review is screening, not sales.
Recovery from facet joint injections is intentionally faster than from traditional open spine surgery or fusion. Most patients return to office work within one to two weeks; manual labor takes four to six weeks. Routine post-operative follow-up is included in the bundled price, and for out-of-town patients much of the follow-up happens remotely through phone or secure video — the 3-day plan documents typical visit cadence. Authoritative clinical background on this procedure is also available at Cleveland Clinic — Facet Joint Injection for patients who want to read more about the underlying evidence.
Frequently asked
How long does the relief last?
Variable. Weeks to a few months for many patients; some experience longer or shorter benefit. The diagnostic information from the injection’s effect is often valuable regardless of duration. To find out whether you’re a candidate for facet joint injections, submit your imaging through the free MRI review — Dr. McMillan reviews each scan personally and provides candid candidacy assessment within several business days.
Is the injection painful?
The skin and needle path are anesthetized first. Most patients describe pressure rather than sharp pain during the procedure itself. Brief soreness afterward is common. To find out whether you’re a candidate for facet joint injections, submit your imaging through the free MRI review — Dr. McMillan reviews each scan personally and provides candid candidacy assessment within several business days.
How many can I have?
There’s no fixed cap, but most clinicians limit corticosteroid injections in a year to avoid systemic effects. Specific recommendations depend on the patient and the response to prior injections. For background on the most common diagnosis treated with this procedure, see the facet joint syndrome page, which covers symptoms, diagnostic workup, and treatment options in detail.
What if the injection doesn't help?
That’s useful information — it suggests the facet joint may not be the primary source of the pain. The next step is to look elsewhere or pursue a different intervention. For background on the most common diagnosis treated with this procedure, see the facet joint syndrome page, which covers symptoms, diagnostic workup, and treatment options in detail.
Are facet injections the same as epidural steroid injections?
No. Facet injections target the small joints between vertebrae. Epidural steroid injections place medication in the epidural space around nerves. Both have their indications. Transparent bundled pricing for facet joint injections is published openly at /spine-surgery-cost-transparent-pricing/, so you can plan financially before scheduling and avoid surprise bills.
Will insurance cover it?
Most major insurers cover facet injections for appropriate indications. Specifics depend on the plan and on the documentation. Transparent bundled pricing for facet joint injections is published openly at /spine-surgery-cost-transparent-pricing/, so you can plan financially before scheduling and avoid surprise bills.
How this page was prepared
This page summarizes the clinical approach taken at Synergy Spine Center for the topic above. It is based on peer-reviewed literature, professional society guidelines (NASS, AAOS), federal patient education resources (NIH, AHRQ, CMS), and Dr. McMillan’s experience as Director of Spinal Medicine and Endoscopic Spinal Surgery. Outcome language is qualified. Individual results vary. Pricing where shown is current for 2026 and may change.
References
- OrthoInfo — back pain injection treatments. — source
- NASS — facet injection resources. — source
- PubMed — clinical literature on facet injections. — source
- Cleveland Clinic — Facet Joint Injection — clinical reference relevant to facet joint injections.
- PubMed — Facet Joint Injection — clinical reference relevant to facet joint injections.
Synergy Spine Center publishes patient education content for general information only; it is not medical advice and does not establish a physician-patient relationship. For specific medical guidance, schedule a consultation. No identifiable patient information is included on this page.