Facet Joint Injections in Manhatten

Facet Joint Injections at our Manhattan, NY location offer precise, image-guided relief for spinal joint pain, serving as both a targeted treatment and a valuable diagnostic tool in the evaluation of chronic neck and back pain.

Not All Back and Neck Pain Comes From a Disc or a Nerve

Facet joints are among the most common and most frequently overlooked sources of chronic spinal pain. When these small paired joints degenerate or become inflamed, the resulting axial neck or back pain can be persistent, limiting, and remarkably difficult to distinguish from disc-related pain without a careful evaluation. At Gerling Spine Care and Research Institute, facet joint injections are a key component of our diagnostic and conservative treatment toolkit for Manhattan patients dealing with chronic spinal pain of uncertain origin.
Contact our Manhattan office today to find out whether Facet Joint Injections are the right next step for you.

What Are Facet Joint Injections?

Facet joints are small paired joints located along the back of the spine at each vertebral level. They guide and constrain spinal movement, provide stability, and, like any synovial joint in the body, are subject to degeneration, inflammation, and injury over time. A facet joint injection delivers a combination of local anesthetic and corticosteroid directly into the affected joint capsule, reducing inflammation and relieving pain at its source. The procedure is both therapeutic, providing relief from joint pain, and diagnostic, helping confirm whether the facet joint is the primary contributor to a patient's symptoms. This dual function makes it particularly valuable in the workup of chronic axial spinal pain, where multiple potential sources exist.

Where Can Facet Joint Injections Be Performed?

Facet joint degeneration can occur at any level of the spine. Our Manhattan team performs injections across all three regions depending on the location of the patient's pain.

Cervical Facet Joint Injections

Cervical facet injections target the joints of the neck and are used to treat chronic axial neck pain, as well as referred pain into the shoulders and upper back that originates from the cervical facet joints rather than from disc or nerve pathology. Cervical facet disease is a significant contributor to chronic neck pain in a large proportion of patients.

Thoracic Facet Joint Injections

Thoracic facet injections address the mid-spine and are used for patients with upper or mid-back pain originating from thoracic facet joints. Less commonly performed than cervical or lumbar injections, they can be highly effective when the thoracic facets are confirmed as the pain source.

Lumbar Facet Joint Injections

Lumbar facet injections are among the most frequently performed spinal injections in clinical practice. They treat lower back pain caused by facet joint arthritis, injury, or degeneration, and are particularly well suited to patients with axial low back pain that worsens with extension and rotation but does not radiate significantly below the knee.

Conditions Treated With Facet Joint Injections

Facet joint injections are appropriate when the facet joints are identified as a likely contributor to a patient's chronic spinal pain. They are used to evaluate and treat:

Facet joint arthropathy and osteoarthritis
Facet joint syndrome at any spinal level
Degenerative spondylosis with facet joint involvement
Spinal pain following injury, whiplash, or repetitive stress
Mechanical neck or back pain with a suspected facet origin
Spinal stenosis with a significant facet contribution to symptoms

They are typically considered after first-line conservative treatments, including physical therapy and oral anti-inflammatory medications, have not provided adequate relief.

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Are You a Candidate for Facet Joint Injections in Manhattan?

Good candidates generally have moderate to severe axial spinal pain lasting three months or longer, imaging findings showing facet joint changes that correspond with their clinical presentation, and a pain pattern consistent with facet joint origin, typically pain that is centralized in the neck or back, worsens with extension or lateral bending, and does not radiate significantly into the limbs. Facet injections may not be appropriate for patients whose pain is primarily driven by nerve root compression, disc herniation, or other non-facet pathology, or for those with active infection, bleeding disorder, or relevant medication contraindications. Our Manhattan team will conduct a thorough clinical evaluation before recommending any injection, considering the full clinical picture rather than imaging findings in isolation.

What to Expect From Facet Joint Injections in Manhattan

Facet joint injections are straightforward outpatient procedures with minimal downtime. Most Manhattan patients complete their appointment within an hour and return to normal activities the following day.

Before Your Facet Joint Injection

Your consultation will include a review of your symptoms, imaging, and prior treatment history. Our team will explain the procedure clearly, outline what a positive or negative response means for your ongoing care plan, and provide specific pre-procedure instructions regarding medications, particularly for patients on blood thinners.

The Day of Your Surgery

You will lie face down on the procedure table while the injection site is cleaned and numbed with a local anesthetic. Using fluoroscopic guidance, the needle is advanced precisely into the target facet joint, and the medication is delivered. The procedure typically takes less than 30 minutes. Some patients experience mild soreness at the injection site for one to two days following the procedure, which resolves on its own.

Recovering After Your Procedure

Most patients return to normal activities the day after the injection. The anesthetic component provides immediate but short-lived relief, while the corticosteroid typically reaches its full effect within several days. Many patients experience relief lasting several weeks to several months. If facet injections confirm the joint as the pain source but relief proves short-lived, medial branch block injections and radiofrequency ablation may be discussed as a more durable next step.

Why Choose Gerling Spine Care and Research Institute?

Chronic spinal pain that has not responded to standard treatment often requires a more systematic diagnostic approach before the right solution becomes clear. Our Manhattan team brings that systematic thinking to every case, combining interventional precision with the broader clinical context that comes from managing the full spectrum of spinal conditions. Patients who have been told their pain is untreatable, or who have tried injections elsewhere without success, will find a team here that is genuinely invested in finding the right answer.

Facet Joint Injections Frequently Asked Questions

How is a facet joint injection different from an epidural injection?

An epidural injection delivers medication into the epidural space surrounding the spinal cord and is used primarily for nerve-related pain radiating into the arms or legs. A facet joint injection delivers medication directly into the facet joint capsule and is used for axial pain originating from those joints, which does not typically radiate in a clear dermatomal pattern.

How do I know if my pain is coming from the facet joints?

Facet pain is typically felt as axial neck or back pain that worsens with extension and rotation and does not prominently radiate below the elbow or knee. A diagnostic facet joint injection using local anesthetic alone is one of the most reliable ways to confirm the facet joint as the primary pain source.

How many facet joint injections will I need?

Some patients experience lasting relief from a single injection. Others benefit from a series. Most guidelines recommend no more than three injections per year at a given level. If repeated injections confirm the facet joints as the pain source but provide only temporary relief, radiofrequency ablation of the medial branch nerves may offer a more sustained solution.

What if the injection does not relieve my pain?

A lack of meaningful relief following a diagnostic facet injection suggests the facet joints may not be the primary pain generator. This is diagnostically useful information that helps focus the evaluation elsewhere. Our team will reassess your clinical picture and explore alternative diagnoses and treatment strategies.

Are facet joint injections covered by insurance?

Facet joint injections are typically covered by insurance, though prior authorization is commonly required. Our Manhattan team will work with you to ensure the appropriate documentation is in place and that the process is as straightforward as possible before your procedure.