For patients in the west LA area — Marina del Rey, Tarzana, Encino, Sherman Oaks, Santa Monica, Culver City, and surrounding communities — facet joint injections may be part of the picture if you are dealing with chronic axial back or neck pain. This guide explains what facet injections are, who benefits from them, and what the procedure involves.
When Facet Injections Are Used
Facet joint injections are used for pain arising in the facet joints — the small paired joints on the back of each vertebra. Facet-mediated pain tends to have a specific pattern:
- Axial (centered in the back or neck, not radiating down a limb in a nerve pattern)
- Worsens with extension — arching backward
- Worsens with rotation — twisting
- Often worse with prolonged standing
- May be worse transitioning from sitting to standing
- Does not typically include nerve symptoms (no shooting leg pain, no arm numbness or weakness in a specific nerve distribution)
When the pattern and physical examination suggest the facet joints are the source, facet injections (and related procedures) become a reasonable part of the plan.
Diagnostic Versus Therapeutic Approaches
Facet joint pain is often confirmed with a medial branch block — a diagnostic procedure in which a local anesthetic is placed precisely at the small nerves carrying pain signals from the facet joints. If the pain is significantly relieved during the duration of the anesthetic, that is strong evidence the facets are the source.
For therapeutic treatment:
Therapeutic facet injections combine an anesthetic with a corticosteroid, injected into or near the facet joint to reduce inflammation.
Radiofrequency ablation (RFA) is used for patients who have responded well to diagnostic blocks. RFA disrupts the pain signal from the medial branch nerves, typically providing longer-lasting relief than an injection.
What the Procedure Involves
A typical facet injection or medial branch block includes:
- Preparation, with the patient positioned face-down on an imaging table
- Small injections of local anesthetic to numb the skin at each target site
- Image-guided needle placement under fluoroscopy
- Contrast dye used to confirm placement
- Injection of the therapeutic medication
- Brief observation and discharge with post-procedure instructions
The procedure itself typically takes 15 to 25 minutes.
What to Expect After
Timing of effect. For therapeutic facet injections, some patients feel relief within days; for others it takes longer.
Duration of relief. Weeks to months for therapeutic injections; often longer for radiofrequency ablation.
Post-procedure experience. Mild soreness at the injection site for a day or two is common. Most patients drive home afterward.
What the injection does not do. It does not fix the underlying arthritic changes. It reduces inflammation and, when effective, provides a window of improved function.
Access for West LA Patients
Southwest Pain Management’s Woodland Hills clinic serves many west LA patients. The clinic is accessible from much of the west side and San Fernando Valley. We also have locations in Ventura and Hawthorne. Clinical approach is consistent across all three.
How Facet Care Fits Into a Broader Plan
Facet procedures are typically one part of a larger treatment approach:
- Diagnosis-matched treatment — interventional care directed at the specific source
- Physical therapy focused on core stabilization and addressing the mechanical contributors
- Activity adjustments that reduce ongoing strain on the facets
- Medication support as appropriate
- Reassessment over time
Durable improvement typically comes from combining an effective procedure with the rest of the plan.
Facet Joint Care at Southwest Pain Management
Our clinics perform the full range of facet joint diagnostics and treatments — diagnostic medial branch blocks, therapeutic facet injections, and radiofrequency ablation. All procedures are performed with image guidance.
Frequently Asked Questions
Are facet injections safe? Considered generally safe when performed by a trained specialist with image guidance. Your physician will review specific risks.
How long does relief last? For therapeutic facet injections, typically weeks to months. For RFA, typically longer.
Is this the same as an epidural injection? No. Epidurals and facet injections target different structures and are used for different kinds of pain.
Do I need imaging before a facet procedure? Often useful but not always required. Your physician will discuss what imaging, if any, is needed for your specific case.
How do I know if my pain is from the facets? Pattern of pain and physical examination offer clues. Medial branch blocks provide the most reliable confirmation.
Can I have multiple facet injections? Yes, when appropriate. Guidelines exist for reasonable spacing. Your physician will discuss what is appropriate for your situation.
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