If you have pain middle back or in the lower back that has lasted more than six weeks, worsens with twisting or bending, and has not improved with physiotherapy or painkillers, facet joint injections are worth discussing with a specialist. The facet joints are small stabilising joints found at every level of the spine, from the neck down to the lower back, and when they become inflamed they are a common but frequently overlooked cause of persistent back pain. At Renew Skin and Health Clinic in Leamington Spa, facet joint injections are performed by Mr Amit Amit, a Consultant Neurosurgeon, under ultrasound guidance, priced from £695 depending on how many levels and sides are treated. Full details of his background are on his specialist profile page.
Table Of Contents
What Causes Middle and Lower Back Pain from the Facet Joints?
The facet joints are small joints located between each vertebra, running the full length of the spine. They help stabilise the back and allow controlled movement. When they become irritated or inflamed, the pain can be felt in the middle back, the lower back, or both, depending on which level of the spine is affected.
- Degenerative changes associated with age
- Poor posture or prolonged desk based work
- Repetitive strain or occupational overuse
- A previous spinal injury or trauma
- Arthritis of the facet joints
- Inflammatory conditions such as ankylosing spondylitis
Because facet joint pain shares symptoms with several other back conditions, it is frequently misdiagnosed, which means many patients go without effective treatment for far longer than necessary.
Signs and Symptoms of Facet Joint Pain
The first signs of facet joint pain are often subtle and easy to mistake for general muscular back pain. Symptoms that point more specifically to the facet joints include
- Localised aching or stiffness in the middle or lower back
- Pain that worsens with twisting, bending, or spinal rotation
- Discomfort after prolonged sitting or standing
- Reduced spinal flexibility and range of movement
- Referred pain into the chest wall, ribs, or hips depending on the spinal level involved
If your pain consistently worsens with rotation or extension of the spine, rather than with forward bending, this is a pattern more typical of facet joint involvement than of a disc related problem, and is worth raising directly at your consultation.
Patients are often advised to avoid heavy twisting exercises or high impact activity while facet joint pain is unconfirmed, since these can aggravate the joint further before a diagnosis is made.
Types of Facet Joint Injections
| Injection Type | Injection Location | Purpose |
|---|---|---|
| Intra articular facet injection | Directly into the facet joint | Diagnostic and therapeutic pain relief |
| Medial branch nerve block | Near the nerves supplying the facet joint | Primarily diagnostic, confirms the pain source |
| Facet injection, ultrasound guided | Facet joints at the affected spinal level | Targeted relief for middle back, lower back, or both |
A diagnostic facet joint injection, most often a medial branch nerve block, is sometimes used first to confirm the facet joint as the true source of pain before a longer lasting therapeutic injection is planned.
When to Consider Facet Joint Injections?
Facet joint injections are generally worth considering for patients who
- Experience persistent middle or lower back pain lasting more than six weeks
- Have not achieved adequate relief from physiotherapy, painkillers, or rest
- Show signs of facet joint involvement on clinical assessment or imaging
- Wish to avoid or delay spinal surgery
- Are seeking a same day, minimally invasive treatment option
Whether the answer to are facet joint injections worth it is yes for you specifically depends on an accurate diagnosis. Mr Amit Amit carries out a full clinical assessment at consultation before recommending any course of treatment.
Lumbar Facet Joint Injections for Lower Back Pain
While the main treatment page focuses on middle back pain, the same facet joint injections approach applies to the lower spine. Lumbar facet joint injections target the facet joints in the lower back, commonly at levels such as L4 and L5, and follow the same ultrasound guided technique used for the thoracic spine. Patients researching a specific level such as an L4 or L5 facet joint injection should still start with a full clinical assessment, since the exact level treated depends entirely on where the imaging and examination point to the problem.
Facet Joint Injections Side Effects
Facet joint injections side effects are generally mild. Most patients experience some soreness at the injection site for twenty four to forty eight hours. It is also common, and expected, for pain to feel slightly worse for a day or two immediately after the injection before it begins to settle, as the tissue responds to the needle and the medication starts to take effect.
Long term side effects are not typically reported when injections are performed under proper ultrasound guidance by an experienced specialist. Any injection carries a small general risk of infection or bleeding at the injection site, which Mr Amit will explain fully before treatment.
What to Expect During the Procedure?
| Step | What Happens |
|---|---|
| 1 | A thorough clinical assessment is carried out and any existing imaging is reviewed |
| 2 | The skin over the treatment area is thoroughly cleaned and a local anaesthetic is applied |
| 3 | The needle is guided precisely to the target facet joint using real time ultrasound |
| 4 | Anti inflammatory medication is injected carefully and accurately |
| 5 | A short observation period follows before the patient is discharged the same day |
The facet joint injection procedure is quick and is typically completed as a same day treatment. Most patients are able to resume their normal daily activities within twenty four hours.
Results and Recovery After Facet Joint Injections
Following the procedure, patients can typically expect mild soreness at the injection site for twenty four to forty eight hours, pain relief that may begin within hours or build gradually over several days, and results that can last from several weeks to several months depending on individual response. Repeat injections may be considered if the initial treatment proves effective.
What If Facet Joint Injections Do Not Work?
If facet joint injections do not provide adequate relief, or symptoms return after a period of improvement, further options may include
- A repeat course of diagnostic or therapeutic injections
- Structured physiotherapy or spinal rehabilitation
- Radiofrequency ablation for longer term relief
- A specialist pain management review with Mr Amit
Treatment pathways at Renew Skin and Health Clinic are always personalised. Mr Amit Amit reviews your response to treatment and adjusts the management plan accordingly rather than offering a one size fits all approach.
Facet Joint Injection Treatment at Renew Skin & Health Clinic
At Renew Skin and Health Clinic in Leamington Spa, all facet joint injections are performed by Mr Amit Amit, a GMC registered Consultant Neurosurgeon with over 25 years of experience, entered on the GMC Specialist Register in Neurosurgery, under real time ultrasound guidance for precision and safety.
| Facet Injection Treatment, What Is Included | Included |
|---|---|
| Specialist consultation with Mr Amit Amit | £300, credited against treatment if proceeding the same day |
| Facet joint injection, one level, one side | £695 |
| Facet joint injection, two levels or both sides | £850 |
| Each additional level | £150 |
| Ultrasound guidance, x ray if required | Included |
All treatment fees are transparent, with the exact price confirmed once the number of levels and sides needing treatment is assessed at consultation. For a full breakdown of all treatment fees, visit our price list. Mr Amit also treats a wider range of pain and spinal conditions, including joint injections, migraine injection treatment, and our full rheumatology and pain management services.
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Book Your Facet Joint Injection Consultation at Renew Clinic
Consultations with Mr Amit Amit are private, discreet, and based on a thorough clinical assessment of your specific back pain.
Call: +44 1926 422 454
WhatsApp: +44 1926 422 454
Email: info@renewskinandhealthclinic.co.uk
Address: Renew Skin & Health Clinic, 18 Guy Street, Leamington Spa, CV32 4RT, United Kingdom
Opening Hours: Monday to Friday, 10:00 AM – 6:00 PM (Telephone lines open daily 9:00 AM – 10:00 PM, including weekends)
Medically Reviewed by Mr Amit Amit, Consultant Neurosurgeon, GMC 6047850
Over 25 years of clinical experience | Member of BASS, Eurospine, and the Society of British Neurological Surgeons
Renew Skin and Health Clinic, 18 Guy Street, Leamington Spa | August 2026
Frequently Asked Questions
1. What are the first signs of facet joint pain?
Early signs include localised aching or stiffness in the middle or lower back, discomfort after sitting or standing for a while, and pain that is noticeably worse with twisting, bending, or rotating the spine.
2. Are facet joint injections worth it?
For patients with confirmed facet joint pain who have not responded to physiotherapy or painkillers, injections often provide meaningful relief and can help avoid or delay surgery. Suitability is confirmed through a clinical assessment rather than assumed from symptoms alone.
3. How long does it take to recover from a facet joint injection?
Most patients resume normal daily activities within twenty four hours. Some soreness at the injection site is common for a day or two, and strenuous activity is best avoided for a short period following treatment.
4. Is a facet joint injection the same as a cortisone injection?
A facet joint injection typically combines a corticosteroid, sometimes called cortisone, with a local anaesthetic, delivered precisely into or near the facet joint. The cortisone is the anti inflammatory component of the injection rather than a separate treatment.
5. What next if facet joint injections do not work?
Options include a repeat course of injections, structured physiotherapy, radiofrequency ablation for longer term relief, or a specialist review with Dr Amit to reassess the diagnosis and treatment plan.
6. Are facet joint injections painful?
Most patients experience only mild discomfort, since a local anaesthetic numbs the area and the injection is guided precisely using real time ultrasound.
7. How many facet joint injections can I have?
The number of injections depends on individual response. Some patients need only one course, others benefit from repeat injections if the initial treatment proves effective. Mr Amit reviews this at follow up.
8. Can facet joint injections replace surgery?
For many patients, facet joint injections provide sufficient relief to avoid or delay surgery. They are not a substitute for surgery in every case, and Dr Amit will advise honestly where surgical assessment is more appropriate.
9. What are the long term effects of facet joint injections?
When performed under proper ultrasound guidance by an experienced specialist, long term side effects are not typically reported. Any injection carries a small general risk of infection or bleeding, which is explained fully before treatment.
10. How much do facet joint injections cost privately in the UK?
At Renew Skin & Health Clinic, facet joint injections start from £695 for one level on one side, rising to £850 for two levels or both sides, with £150 for each additional level. Consultation is £300, credited against treatment if you proceed the same day.