Spinal Facet Injections in New York City
Sports + Pain Institute of New York (SPIN) provides spinal facet joint injections at our Midtown Manhattan clinic. If you experience chronic neck, mid-back, or lower back pain that worsens when twisting, bending, or staying in one position, facet joint injections may provide the targeted, lasting relief you need.
Our board-certified pain specialists, including Dr. Febin Melepura, use real-time fluoroscopic X-ray guidance to deliver a precise combination of local anesthetic and corticosteroid directly into the affected facet joint. Sessions take 15 to 30 minutes, and same-day appointments are available.
Spinal Facet Injections NYC — SPIN Sports Pain Specialists
Ready to find relief from spinal facet pain?
Same-day appointments available for spinal facet injection evaluation and treatment.
Why Choose Spinal Facet Joint Injections?
A lumbar facet injection can relieve lower back pain. In fact, spinal facet injections provide some of the leading treatments your sports medicine team offers. Lumbar, cervical, and thoracic facet joint injections are designed to reduce inflammation and pain in those tender areas of your back that get regular workouts. A cervical facet joint injection reduces neck pain, so if you work at a computer, a cervical facet injection or cervical facet block injections ease the discomfort of poor posture and improper ergonomics. Make an appointment in our New York pain management clinic to get your back pain evaluation and relief.
Your spine is strong and flexible. Back pain occurs when your spine is damaged or diseased. Your Midtown Manhattan sports medicine and pain management doctor offers injections that can provide dramatic pain relief. Whether you need a thoracic joint injection or lumbar facet injections, the team at SPIN can help.
When giving a facet joint injection, your doctor uses x-ray imagery to inject the joint with a medication consisting of an anesthetic numbing agent and anti-inflammatory steroids. This procedure relieves pain caused by the facet joint.
Some of the most common places your NYC doctor treats facet joint pain are in the neck and the lower back. Facet pain in the neck, head, and shoulders may require a cervical facet joint injection. Upper back and chest pain caused by facets in the upper spine are treated with a thoracic facet injection. Lower back, hip, and gluteal pain from facets indicate treatment with a lumbar facet joint injection.
Facet joints are made of cartilage and are responsible for your flexibility and ability to bend and twist. Your nerves pass through them to go to other parts of your body. Facet joint syndrome is the leading cause of back pain because the joints are almost constantly in use. Athletes face heightened risk due to pressure from twisting and movement.
Conditions We Treat with Facet Joint Injections
At SPIN, we use facet injections to diagnose and treat:
Facet joint syndrome
arthritis of the spinal facet joints causing localized back pain and stiffness
Lumbar facet pain
lower back pain that worsens with spinal extension or prolonged standing
Cervical facet pain
neck and shoulder pain that may cause cervicogenic headaches
Thoracic facet pain
mid-back pain from poor posture, repetitive strain, or prior injury
Spondylosis
age-related spinal degeneration inflaming the facet joints
Degenerative disc disease
disc wear that stresses the adjacent facet joints
Sports injuries
facet joint strain from rotational or impact forces
Facet injections also work as a diagnostic tool. If your pain improves significantly after the injection, the facet joints were likely the source - which guides your long-term treatment.
Facet Injection vs. Epidural: What Is the Difference?
Both procedures target spinal pain but work on different structures. Here is how they compare:
Facet Joint Injection
- Target: Facet joints (small vertebral joints)
- Best for: Localized back or neck pain that stays in the spine without radiating
- Pain pattern: Axial - does not travel down a limb
- Relief duration: Up to 6 months
- Diagnostic value: High - confirms facet joint as the pain source
Epidural Steroid Injection
- Target: Epidural space around the spinal cord and nerve roots
- Best for: Radiating pain (sciatica), disc herniation, nerve compression
- Pain pattern: Shoots down an arm or leg
- Relief duration: 3 to 6 months
- Diagnostic value: Moderate
How we decide: Dr. Melepura evaluates your pain pattern, reviews imaging, and does a physical exam. Axial pain that stays in the spine typically calls for a facet injection. Radiating limb pain typically calls for an epidural. Both procedures can be combined when multiple pain sources are present.
Ready to find relief from spinal facet pain?
Dr. Melepura's Midtown Manhattan clinic offers same-day appointments for evaluation and treatment.
What to Expect During Your Facet Injection at Our NYC Clinic?
A lumbar facet injection, cervical facet joint injection, and thoracic facet injection are outpatient procedures normally done without anesthesia. The actual injections take only minutes. Overall, the procedure may last 15 to 30 minutes. While you lie on an x-ray table, your Midtown Manhattan sports injury doctor disinfects and numbs the target area. Using x-ray imagery for guidance, he inserts a small needle into the painful joint. A tiny amount of contrast dye is released to guarantee correct needle placement. Once confirmed, the medication is released into the joint.
Before the Procedure
You will check in at our Midtown Manhattan office. No general anesthesia is required. A topical numbing cream or mild sedation may be offered. You will be positioned face-down on a padded procedure table and the skin over the injection site will be cleansed and numbed.
During the Procedure
Using live fluoroscopic X-ray guidance, Dr. Melepura guides a thin needle precisely into the affected facet joint. A small amount of contrast dye confirms accurate placement. A combination of local anesthetic and corticosteroid is then delivered into the joint. The procedure takes 15 to 30 minutes.
After the Procedure
You will rest in our recovery area for 20 to 30 minutes. Then your doctor gently guides you through movements that would normally trigger your pain. The movements your doctor has you go through are designed to determine if your facet joints really were the source of your pain. You need a driver for the day of the procedure. Most patients resume normal light activity the following day. Mild soreness at the injection site is normal and resolves within 24 to 48 hours. If you do have discomfort, you can simply ice the sore area.
For medial branch blocks, the entire procedure is the same except that the needle is inserted into the space around your facet joints to block the nerves supplying them. If this procedure provides pain relief (which is temporary), you will be offered the radiofrequency ablation of the medial branch nerves.
How Long Do Facet Injections Last?
Relief should be immediate because of the anesthetic. Two to five days later, you should experience even longer-lasting pain relief as the anti-inflammatory agent kicks in. You can expect to see a significant reduction of your pain within two weeks at most.
Whether you receive a lumbar facet injection, a thoracic facet injection or a cervical facet injection, the results are powerful if the facet joints are the source of your pain. If the pain is not corrected by the facet injections, they do provide further diagnostic information critical to locating the real source of your pain.
If injections provide diminishing relief over time, radiofrequency ablation of the medial branch nerves may be a more durable long-term solution.
Risks and Benefits of Spinal Facet Injections
The risks from this procedure are minimal. However, any medical procedure does carry some potential for risk. Although rare, possible risks include:
Allergic reaction
Bleeding
Nerve or spinal cord damage
Discomfort at the point of injection
Slight numbness in your back or neck that normally disappears after a couple of hours
Most people agree the slight risks are worth it for the relief from constant pain. Talk to your experienced sports pain management specialist about your odds of making a full recovery after receiving cervical facet injections. Pain relief may last for as long as six months, which gives your body time to heal. Rest and activity modification, compounded by pain relief, often can be the best treatment, helping you avoid surgical options.
You need an expert diagnosis to get the best results. That's what you receive at SPIN. Your medical team solves your pain problems. They get you out of pain and back in the game. The cervical facet block injections and the lumbar facet joint injection are the gold standards for properly diagnosing facet joints as the source of your spinal pain, while giving you a reprieve from a life of pain and limited mobility.
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Dr. Febin Melepura, MD
Double Board-Certified Pain Specialist
Meet Dr. Febin Melepura - Your Spinal Facet Injection Specialist in NYC
Dr. Febin Melepura, MD is a double board-certified interventional pain management specialist and the founder of the Sports Pain Institute of New York. He completed his residency and fellowship training at New York Presbyterian Hospital / Columbia University Medical Center, one of the nation's leading academic medical centers.
He holds dual board certifications from the American Board of Anesthesiology and the American Board of Pain Medicine, and has treated more than 7,500 patients and performed over 5,250 procedures throughout his career. He has been named a Top Pain Management Doctor in New York and one of America's Top Doctors™ by Castle Connolly.
Dr. Melepura's approach to spinal facet pain is rooted in precision: identify the exact source, treat it with a targeted injection, and get you back to your daily life as quickly as possible.
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"Able to make an appointment to see Dr. Melepura on short notice… attentive to my concerns… Jazmin was also very kind and helpful."
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"I felt listened to and truly understood by Dr. Melepura. Started PT the very next day. They were very friendly and I didn't feel rushed at all. Already recommended them to my friends who have or continue to play through pain."
Frequently Asked Questions About Spinal Facet Injections
Most patients feel minimal discomfort. We numb the skin and tissue with local anesthetic before the procedure. You may feel mild pressure when the needle is positioned, but significant pain is uncommon. Mild oral sedation is available if needed.
A facet injection delivers a corticosteroid and local anesthetic directly into a facet joint - the small paired joints connecting adjacent vertebrae in your spine. It is performed under fluoroscopic X-ray guidance and is used to reduce inflammation and block pain signals.
Relief typically lasts three to six months, with some patients experiencing up to a year of benefit. Many patients receive two to three injections per year as part of an ongoing pain management plan.
A facet joint injection places medication directly inside the joint capsule. A medial branch block targets the nerves supplying the joint without entering it. Both treat facet pain - Dr. Melepura will recommend the right approach based on your condition.
Guidelines recommend no more than three to four injections per joint per year to limit steroid exposure. If injections stop providing adequate relief, radiofrequency ablation may be considered next.
A facet injection targets the joint itself. An epidural goes into the space around the spinal cord and nerve roots. Facet injections treat axial spine pain; epidurals treat radiating limb pain from nerve compression. See the comparison section above for full details.
No, the medial branch block is a very safe procedure. Especially when performed by a qualified pain specialist who is an expert with these types of spine procedures.
You may feel transient discomfort at the injection site. If the injection spills into nearby nerves, there will be temporary weakness and numbness. There's also a slight risk of infection at the injection site. However, this is very rare.
A cervical medial branch block is done when you're having pain in your neck region to block the nerves feeding the facet joints in that area. A thoracic medial branch block involves blocking the nerves supplying the facet joints in your mid-back. Similarly, a lumbar medial branch block is done to block the nerves in the lower back in patients with lower back pain.
Most patients will find relief within the first few hours of the injection. If there's no relief, it is likely that the medial branch nerves were not the cause of pain.
Schedule Your Facet Injection Consultation in NYC
If you are dealing with chronic neck or back pain in New York City, SPIN's board-certified pain specialists can evaluate and treat you quickly. We serve patients throughout Midtown Manhattan, the Upper East Side, Upper West Side, and surrounding NYC neighborhoods. Same-day appointments are available and most major insurance plans are accepted.
Call (212) 621-7746 or book online at sportspainmanagementnyc.com.