Targeted Relief for Spinal Joints.

When spinal pain flares, time‑tested, image‑guided procedures can quickly calm inflamed joints or irritated nerves to restore function and create a window for rehabilitation. We tailor each procedure to your diagnosis and goals, using fluoroscopic (X‑ray) guidance for accuracy and safety.

How do we choose and perform this procedure?

Careful diagnosis: We correlate your history, exam, and imaging (often MRI) to pinpoint whether pain is facet‑mediated (joint) or radicular (nerve root).  

Facet joint injection (intra‑articular): A small dose of corticosteroid and anesthetic is placed inside the painful facet joint to reduce synovitis and capsular irritation. Can be therapeutic and/or prognostic.  

Medial branch blocks (diagnostic): Tiny amounts of anesthetic are placed on the nerves that supply the facet joints. Short‑term relief confirms the facets as the pain source and helps predict benefit from RFA.

Radiofrequency ablation (RFA): If diagnostic blocks are positive, heat is used to precisely interrupt the medial branch nerves that carry facet pain signals, often providing months of relief.

Epidural steroid injection (ESI): Corticosteroid is delivered to the epidural space (transforaminal, interlaminar, or caudal approach) to reduce inflammation around a pinched nerve root and relieve leg or arm pain.

Common injuries and conditions treated.

Facet Joint Arthritis

Wear and tear in the small joints of the spine (neck, mid-back, or low back), typically exacerbated by extension and rotation.
Facet capsular injuries typically result from acute high-impact events, such as motor vehicle accidents, or repetitive strain in sports like gymnastics, dance, and football.
Pondylolysis and Spondylolisthesis: Fracture of the pars interarticularis, often causing facet pain without overt instability. Common in skiing accidents or sports involving repetitive extension.
Occipital headache: Pain that is often referred from the upper cervical facet joints.
Facet Synovial Cysts: Painful cysts in the spine that may press against nearby nerves, causing radiating pain or numbness.

Radiculopathy and Radiculitis

These conditions occur when a spinal nerve is compressed or “pinched,” leading to pain and numbness that travels down the leg. In more advanced cases, it can cause muscle weakness. This is usually caused by a damaged disc or arthritis narrowing the spaces where nerves exit the spine (foraminal narrowing).

What to expect.

Visit Length

Visit Length: 20-30 minutes for facet and epidural injections; 30-60 minutes for RFA. This is an outpatient procedure; you will return home the same day.

Onset and Duration

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Activity Protocol

Facet & Epidural Injections: Protection, light activity, and gentle range-of-motion exercises for the first 3 days. Expect the maximum benefits within 3 to 7 days.
Facet Ablations (RFA): Light activity recommended for the first few days. Expect the maximum benefits within 7 to 14 days.

Results

Facet & Epidural Injections: Immediate relief may occur, though peak benefits usually take a few days for facet injections and 7–14 days for epidural injections.
Facet Ablations (RFA): Immediate relief may occur, though peak results usually occur at 1 to 2 weeks.

Safety

While classic injections are generally considered very safe, rare complications can occur. These include, but are not limited to severe allergic reactions, vascular injury, nerve damage or spinal cord injury, embolism, or bleeding and infection of deep spaces in the spine.

Medications

Before your procedure, coordinate with your primary doctor to safely pause blood thinners. Follow your specialist’s specific timeline for discontinuing these medications and NSAIDs.

Patient Medication Guide

View our Patient Medication Guide.

Why choose traditional spine procedures
with us?

Diagnosis‑driven selection of the right level, side, and approach.

Fluoroscopic accuracy for safer, more effective treatment.

Thoughtful dosing and timing to minimize steroid exposure while maximizing function.

Integrated rehab plan to maintain gains and reduce recurrence.

Balanced counseling on alternatives, including physical therapy, medications, PRP/regenerative options, or surgical referral when indicated.

Is this treatment right for you?

We’ll review your history, imaging, and prior care to determine whether a facet injection, medial branch block with potential RFA, or an epidural steroid injection best matches your diagnosis and goals.

The Science Behind Our Treatments.

What to know more about our evidence based approach? Explore the links below for more information.

Study 1

Cohort study assessing the safety and accuracy of ultrasound-guided cervical facet injections.

Get Back to What You Love

Schedule a consultation to explore non-surgical treatment options that align with your active lifestyle.