Pain Management
Facet Joint Injections
Targeted Pain Relief for Arthritic or Inflamed Spine Joints
The facet joints are small joints in the spine that allow smooth movement. When these joints become arthritic or inflamed, they can cause chronic neck or back pain. Facet joint injections deliver medication directly into these joints to reduce inflammation and confirm whether they are the pain source. At Desert Spine and Pain, neurosurgeon Dr. David L. Greenwald, M.D., FAANS, FACS performs facet injections with fluoroscopic (X-ray) guidance for maximum precision and safety.
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Over 30 Years Experience in Orthopedic & Neuro Spine Surgeries.
What Are Facet Joint Injections?
In simple terms: A small amount of steroid and anesthetic is injected into the facet joints to reduce pain and inflammation.
Scientifically: Facet joint injections involve percutaneous needle placement into the zygapophyseal joint capsule under fluoroscopy, followed by injection of corticosteroid and anesthetic to block nociceptive transmission and confirm diagnosis.
Conditions Treated
Facet joint arthritis (cervical, thoracic, lumbar)
Chronic neck pain or low back pain not relieved by conservative measures
Spondylolysis or facet degeneration contributing to pain
Diagnostic tool before Radiofrequency Ablation
The Facet Injection Procedure: Step by Step
Plain-English Overview
Anesthesia: Local anesthesia and light sedation if needed.
Imaging: Needle guided into the facet joint with live X-ray.
Medication injection: A mix of anesthetic and steroid is injected.
Observation: Short recovery; home the same day.
Surgeon-Level Detail
Positioning: Patient prone; sterile prep and draping.
Needle placement: 22–25G spinal needle advanced into facet joint capsule under AP/oblique/lateral fluoroscopy.
Contrast injection: Confirms intra-articular placement.
Medication: Corticosteroid + anesthetic mixture injected slowly.
Closure: Needle withdrawn; bandage applied.
Benefits of Facet Injections
Targeted relief for facet-related pain
Minimally invasive, outpatient procedure
Diagnostic value: confirms if pain originates from facet joints
May provide months of pain relief
Often used as a bridge to radiofrequency ablation for longer relief
Risks & Limitations
Temporary soreness at injection site
Infection, bleeding, nerve irritation (rare)
Pain relief may be temporary (weeks to months)
Not effective if pain isn’t facet-related
Recovery Timeline
Day 0: Home same day; mild soreness possible
Days 1–3: Pain relief may begin; steroid effect builds gradually
Weeks 1–2: Most patients notice significant relief
Months: Relief can last weeks to months; repeat injections or RFA may be needed
Why Choose Desert Spine and Pain?
Neurosurgical precision: Dr. Greenwald ensures accurate placement under imaging guidance
Patient-first approach: Clear communication, conservative-first philosophy
Full spectrum of care: From injections to RFA to advanced surgery, all options available in one place
Compassionate care: We take the fear out of interventional spine treatments
Frequently Asked Questions
How do I know if facet joints are causing my pain?
Facet pain often worsens with bending backward, twisting, or prolonged standing. Injections help confirm the diagnosis.
How long do facet injections last?
Relief varies—some patients get weeks, others several months. If relief is temporary, RFA may provide longer benefit.
What’s the difference between facet injections and medial branch blocks?
Facet injections deliver medication into the joint. Medial branch blocks target the tiny nerves supplying the facet joints. Both are diagnostic; RFA is the next step if blocks confirm pain source.
Can I return to normal activity after an injection?
Yes. Light activity same day; avoid heavy lifting for 24 hours.
How does Desert Spine and Pain perform these differently?
We use fluoroscopy-guided, neurosurgeon-led precision to maximize safety and effectiveness.
Dr. David L. Greenwald, MD
Neuro-Spine Surgeon
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If you’re suffering from chronic neck or back pain that may be related to arthritis or joint inflammation, facet joint injections could provide the relief you need. Dr. Greenwald and his experienced team will evaluate your condition, review your imaging, and determine whether this minimally invasive treatment is right for you. Every step you take toward pain relief brings you closer to comfort, flexibility, and a stronger spine. Schedule your consultation today and let Dr. Greenwald help you restore movement and live pain-free.
Voted Best Spine Doctor
Over 30 Years Experience in Orthopedic & Neuro Spine Surgeries.
Dr. David L. Greenwald, M.D., F.A.C.S.
Neurosurgeon | Spine Surgeon | Regenerative Medicine
Dr. David L. Greenwald, MD, FACS, is a board-certified spine surgeon with advanced expertise in facet joint injections, a minimally invasive treatment designed to relieve pain caused by inflammation or arthritis in the small joints of the spine. These joints, known as facet joints, help stabilize the spine and allow for smooth motion—but when they become irritated or degenerated, they can lead to chronic neck or back pain. Using precise image-guided techniques, Dr. Greenwald injects a combination of anesthetic and anti-inflammatory medication directly into the affected joints to reduce pain, confirm diagnosis, and improve function. His patient-centered approach and surgical precision have helped countless individuals throughout South Florida regain mobility, comfort, and quality of life through targeted spinal pain management.
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