Focal pain is seen in spinal facet arthropathy. A 25-gauge spinal needle is inserted and advanced into the facet joint under fluoroscopy, followed by contrast media administration for placement confirmation under fluoroscopy. Then a short Luer-lock extension tube is attached to the spinal needle hub to inject the steroid mixture, usually 80 mg methylprednisolone acetate in 1 mL together with 1–2 mL of bupivacaine 0.25–0.5 %. Difficult targeting of or entry into the facet joint due to significant osteophytosis can complicate the procedure. Bleeding and infection are rare complications.