Concierge pain medicine · London
Private facet joint injection in London, fluoroscopy-guided, by a consultant.
Diagnostic and therapeutic facet blocks with proper fluoroscopy guidance — and an RFA pathway when the diagnostic block confirms facet-mediated pain.
Why patients choose us
- 01
Fluoroscopy every time
Facet injections should be image-guided. We book consultants who use fluoroscopy or CT — not landmark technique — so the drug reaches the joint or medial branch nerve.
- 02
MBB before RFA, always
A diagnostic medial branch block confirms the pain is facet-mediated before we go anywhere near radiofrequency ablation. Skipping that step gets poor RFA outcomes.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private facet joint injection costs in London.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options.
In short
A single-level lumbar facet injection in our network: £700-£1,400, with the steroid effect starting in 3-7 days.
| Injection type | Indicative range | Typical duration | Report turnaround |
|---|---|---|---|
| Lumbar facet injection (1-2 levels) | £700–£1,400 | 30 min | Same visit |
| Cervical facet injection | £900–£1,800 | 45 min | Same visit |
| Bilateral lumbar facet injection | £900–£1,800 | 45 min | Same visit |
| Diagnostic medial branch block (MBB) | £750–£1,500 | 30 min | Same visit |
| Radiofrequency ablation (after positive MBB) | £1,800–£3,500 | Half-day | Same visit |
| Facet injection + pain consult | £1,000–£2,000 | Half-day | Same visit |
Prices vary by clinic, by the number of levels injected, and by whether the procedure is a diagnostic block, a therapeutic injection or radiofrequency ablation. We come back with a firm quote within one working day.
The problem
An unguided facet block often misses. Fluoroscopy doesn’t.
Facet joints are small, deep and close to nerves. Blind injections have poor accuracy and poor outcomes. Live X-ray guidance confirms the needle is exactly where the drug needs to go — at every level, on every pass.
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Worried about the needle?
The skin is numbed first. Most people describe pressure and pushing rather than sharp pain.
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Worried about the X-rays?
The fluoroscopy dose is low and pulsed only during needle checks. In pregnancy we defer the procedure unless benefit clearly outweighs risk.
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Sceptical of a quick fix?
You are right to be. The injection buys a pain-free window. Rehab in that window — and, when indicated, RFA — is what changes the trajectory.
The journey
From enquiry to rehab plan — what happens, in order.
One clinician from first message to review — including the physio plan in between, and the RFA pathway when appropriate.
Phase 1 · Before your injection
Concierge, off-stage for you
Phase 2 · On the day
~1 hour at the clinic
Phase 3 · After
Rehab + review
- 01
Before
You tell us where it hurts
A short, confidential form. Symptoms, timeline, any prior MRI or CT, and any medication — especially blood thinners.
- 02
Before
We come back with a recommendation
Within one working day: diagnostic MBB or therapeutic facet block, which consultant, indicative price. If an injection isn’t the right step, we say so.
- 03
Before
We arrange the appointment
Usually within a week. We review medication and diabetes control with the team and tell you exactly how to prepare.
- 04
On the day
Arrival at the clinic
Arrival, consent and prone positioning on the fluoroscopy table. Skin is cleaned and numbed — the only sharp moment is that first local anaesthetic.
- 05
On the day
The injection itself
20-45 minutes. Live X-ray confirms needle position at each level before the steroid and local anaesthetic mix is placed.
- 06
On the day
Home the same day
A short rest and home within the hour. You’ll need someone to drive you — no driving for 24 hours after a spinal injection.
- 07
After
Rehab, review and RFA if indicated
Steroid effect starts within 3-7 days. Physio begins in the same window. If a diagnostic MBB confirms facet-mediated pain, RFA is arranged as the next step.
Typical end-to-end: 1-2 weeks to injection, then 4-6 weeks of rehab before review.
When it helps
When a facet joint injection is the right next step.
Not every back or neck pain needs an injection. These are the situations where a well-placed facet block, alongside rehab, tends to earn its keep.
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Chronic axial back pain
Pain in the low back or paraspinal muscles without leg symptoms — a classic facet pattern.
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Neck-origin headache
Cervicogenic headache and neck pain referred from upper cervical facet joints.
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Degenerative facet disease
MRI or CT showing facet arthropathy that matches the pain distribution.
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Bilateral facet pain
Symmetric low-back pain from bilateral lumbar facet arthropathy, treated in one session.
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Diagnostic MBB
Short-acting local anaesthetic to the medial branch nerve to confirm facet origin before RFA.
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Preparation for RFA
After one or two positive MBBs, radiofrequency ablation gives longer-lasting relief — often 6-12 months.
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Post-fusion facet pain
Adjacent-segment facet pain after lumbar fusion, often overlooked and often treatable.
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Red flag: neurological deficit
New weakness, saddle numbness or bladder change — do not book an injection. MRI first, escalate the same day.
Injection types
Not all facet procedures are the same.
What each option on your referral is actually for — from diagnostic MBB to therapeutic block to radiofrequency ablation.
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Lumbar facet injection
Steroid and local anaesthetic placed into the lumbar facet joint under fluoroscopy — 1 to 2 levels per side.
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Cervical facet injection
Fluoroscopy-guided injection into a cervical facet joint for neck pain and cervicogenic headache.
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Bilateral lumbar
Both sides injected in one sitting when symptoms are symmetric — fewer trips, one recovery.
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Medial branch block (diagnostic)
Short-acting anaesthetic to the medial branch nerve of the facet joint. Positive response confirms facet origin.
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Radiofrequency ablation
Heat lesion of the medial branch nerve after a positive MBB. Longer-lasting relief, typically 6-12 months.
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Facet + pain consult
Injection combined with a formal pain-medicine consultation and rehab plan on the same visit.
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Repeat facet
A repeat therapeutic block where a previous injection has helped but relief has worn off.
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Combined with epidural
When both facet and radicular pain are present, a facet block and a nerve-root or epidural injection in the same session.
Our vetted London network
A small panel of specialists, we picked them.
Consultant pain-medicine specialists and interventional radiologists across central, north, west and south London. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every specialist in our network.
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FRCA-registered consultant pain-medicine specialists placing the injection
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Fluoroscopy or CT guidance standard for every facet block — no landmark technique
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MBB-then-RFA protocol adhered to — no ablation without a positive diagnostic block
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Onward physiotherapy programme arranged alongside the injection
Safety and eligibility
Safer, and simpler, than most people expect.
Facet injections are safe when placed under image guidance. The things worth planning are blood thinners, diabetes control, the RFA pathway, and how many injections you have had at the same level already.
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Infection and nerve irritation
Small risk of infection or transient nerve irritation at the injection site — rare with sterile fluoroscopic technique.
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Blood thinners
Warfarin, DOACs and clopidogrel need planning around the procedure. Never stop them on your own — we coordinate it.
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Driving restriction
No driving for 24 hours after a spinal injection. Arrange a lift home.
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Diabetes
Blood glucose can rise for a few days after a steroid injection — monitor more closely and tell your diabetes team.
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MBB confirms facet origin
A diagnostic medial branch block should always come before RFA. Skipping it is the commonest reason ablation underperforms.
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Frequency limit
Limit steroid to 3-4 injections per year at the same level to protect tissue and bone quality.
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Not a cure
The injection buys a pain-free window. Combine with rehab — that is what changes the trajectory.
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Pregnancy
Fluoroscopy uses X-rays, so facet injections are usually deferred in pregnancy unless the benefit clearly outweighs the risk.
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Bring prior imaging
Always share prior MRI or CT — it helps the consultant target the right level and avoid a repeat scan.
Reading your report
A facet injection report is short. Read the last part first.
Whichever level was injected, the report keeps to the same four parts.
A quiet reminder
The injection is only the start — the rehab plan and, when indicated, RFA are what make it stick.
If you would like us to talk you through it before your physio starts, just ask.
- 01 Header
Indication and prior imaging
The clinical question and the relevant MRI or CT findings — for example "L4/5 and L5/S1 facet arthropathy, axial low back pain".
- 02 Technique
Level, approach and drug
Which level and side were injected, the approach used under fluoroscopy, the drug, dose and any local anaesthetic mixed with it.
- 03 Findings
Fluoroscopy confirmation
A brief note on live X-ray images — needle position confirmed within the facet joint or on the medial branch nerve.
- 04 Impression
Response expected, rehab, RFA candidacy
Read this first. The expected response, the rehab plan, and — if this was a diagnostic MBB — whether RFA is the appropriate next step.
Recognised by major UK insurers
Most policies cover facet joint injections and RFA when clinically indicated; we confirm cover and pre-authorisation before booking.
Frequently asked
Everything we get asked about facet injections.
Quick answers on pain, cost, blood thinners, diabetes, and the RFA pathway.
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What is a facet joint injection?
A facet joint injection is a fluoroscopy-guided injection of steroid and local anaesthetic into or beside the small paired joints at the back of the spine. It is used to treat pain that is coming from the facet joints themselves — most often in the low back or neck.
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What is the difference between a facet injection and an epidural?
They target different structures. A facet injection treats pain from the facet joints — usually axial back or neck pain without leg symptoms. An epidural steroid injection treats pain from an irritated nerve root — usually pain radiating down the leg or arm. Your consultant chooses based on the pattern of pain and the MRI findings.
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Can I drive home after a facet injection?
No — not for 24 hours. Local anaesthetic can temporarily affect leg strength or sensation, and the sedation many clinics offer takes a day to clear. Arrange a lift home.
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I have diabetes — can I still have a facet injection?
Yes, but be aware that blood glucose can rise for a few days afterwards. Monitor more closely for the first week and let your diabetes team know if control drifts.
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How much does a private facet joint injection cost in London?
A single-level lumbar facet injection is typically £700-£1,400. Cervical or bilateral lumbar injections are £900-£1,800. A diagnostic medial branch block is £750-£1,500 and radiofrequency ablation after a positive MBB is £1,800-£3,500. We confirm a firm figure within one working day.
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Do I need a GP referral?
No. Most of our pain-medicine consultants accept self-referrals. If you have any imaging — an MRI or CT report — send it with your enquiry; it usually speeds the decision.
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How many facet injections can I have?
Most guidelines suggest limiting steroid injections at the same spinal level to around 3-4 per year. If a therapeutic injection helps but only briefly, a diagnostic MBB followed by radiofrequency ablation is often the next step.
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What if the injection works — what are my RFA next steps?
If a diagnostic medial branch block gives good short-term relief, that confirms the facet joint as the pain source. Radiofrequency ablation then heats the medial branch nerve to give longer-lasting relief, typically 6-12 months, and the procedure can be repeated when pain returns.
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Will I need physiotherapy afterwards?
Almost always. The injection buys a pain-free window; a rehab plan in that window is what changes the underlying problem. We arrange the physio referral alongside the injection.
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When should I see a GP urgently after a facet injection?
A fever, spreading redness at the injection site, new leg weakness, saddle numbness or bladder or bowel change needs same-day review. Serious complications are rare, but have to be caught quickly.
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Epidural steroid injection
Fluoroscopy-guided epidural for radicular leg or arm pain from an irritated nerve root.
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Spine MRI
The imaging that identifies the facet levels — and rules out other causes — before an injection.
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