Facet joint injections can relieve back or neck pain that comes from the small joints of the spine. Our pain specialist in Singapore uses imaging guidance to place the medicine precisely.
Facet joints are small paired joints at the back of the spine. There is one on each side at every level of the neck, upper back and lower back, and together they guide and limit how the spine bends and twists. Like other joints, they are lined with cartilage and wrapped in a capsule that holds lubricating fluid.
Over time, wear and tear (arthritis), injury or long periods of strain can inflame these joints. The inflamed joint, and the small nerves that supply it, can then become a source of back or neck pain.
Facet joint pain is usually a deep ache in the lower back or neck, felt on one or both sides. Depending on the level involved, it can spread to the buttocks and thighs, or to the shoulders, upper back and the back of the head. It often feels worse when you lean backwards, twist or stay in one position for long, and the area can feel stiff in the morning.
Facet joint pain does not usually cause weakness, or pain that travels below the knee or down the arm. If you have these symptoms, the cause may be a pinched nerve instead, which is treated differently (see epidural steroid injections). Your doctor will assess you for this.
Your doctor starts with your history and an examination. Scans such as an X-ray or MRI can show wear in the facet joints, but this is also common in people with no pain, so a scan alone cannot prove that a facet joint is causing your symptoms.
When the cause is unclear, a medial branch block can help. A small amount of local anaesthetic is placed next to the tiny nerves that carry pain signals from the facet joints. If your pain eases clearly for a few hours, the facet joints are likely to be the source. The block is sometimes repeated on a separate day to be sure.
The two procedures look similar but have different aims.
| Medial branch block | Facet joint injection | |
|---|---|---|
| Main aim | To find out whether the facet joints are the source of your pain | To relieve pain and inflammation in the joint |
| Where the medicine goes | Next to the small nerves outside the joint | Into the joint, or around its capsule |
| Medicine used | Local anaesthetic only | Local anaesthetic and a steroid |
| Usual effect | Short-term relief, from a few hours to a few days | Varies: weeks to months for some people, little benefit for others |
| What may follow | If your pain eases clearly, radiofrequency treatment may be considered | Can be repeated if it helps |
Results vary from person to person. Some people have relief that lasts for weeks to months, which gives a window to move more freely and to strengthen the muscles with physiotherapy. Others get little or short-lived benefit. Research on steroid injections into the facet joints has given mixed results, which is why we confirm the diagnosis first and recommend the injection only when it is likely to help.
If a medial branch block has clearly helped but the relief from injections is short-lived, facet joint denervation (radiofrequency ablation) may give longer-lasting relief.
Facet joint injections are generally safe when done by a trained specialist using imaging guidance. The common effects are mild and short-lived:
Rare risks include infection, bleeding, and an allergic reaction to the medicines or the contrast dye. Injury to a nearby nerve is very rare. Your doctor will go through these risks with you and answer your questions before the procedure.
Please tell us if you:
See a doctor urgently if you develop new weakness or numbness in your legs, lose control of your bladder or bowels, have back pain with a fever, or have back pain after a serious injury.
MOH accredited Pain Specialist and Medical Director of Alleviate Pain Clinic at Farrer Park Hospital. He completed an interventional pain fellowship at the University Health Network in Toronto and was previously a Senior Consultant in Pain Medicine at Singapore General Hospital.
Read more about Dr LiuThis page gives general information and is not a substitute for medical advice. Please see a doctor about your own symptoms and treatment options.
You will feel a needle prick and some pressure as the skin is numbed. The area around the joint is also numbed, so most people find the procedure tolerable. Some soreness for a day or two afterwards is common.
It varies. Some people have relief for weeks to months, while others get little or short-lived relief. Your doctor will explain what to expect in your case.
Steroid injections are usually limited to a few times a year, because repeated steroid doses can cause side effects. Your doctor will advise how often is suitable for you.
Some blood thinners may need to be paused before the procedure, depending on the medicine and the reason you take it. Please do not stop any medicine on your own. Tell us what you take, and we will advise you.
Interventional pain procedures are covered by the Ministry of Health’s Table of Surgical Procedures (TOSP). They are therefore reimbursable by all Integrated Shield Plans and most corporate insurance plans. However, it is advisable to obtain preauthorisation from your insurer before the procedure. Our clinic staff will guide you through this process.
No. You can book a consultation directly. If you have recent scans or medical reports, please bring them along.
Effective pain solutions for a better living. Specialist pain management at Farrer Park Hospital, Singapore.
1 Farrer Park Station Road #08-14
Farrer Park Hospital (Connexion)
Singapore 217562
Mon–Fri 9am–5pm
Sat 9am–1pm · By appointment
