Mechanical derangements of the lumbar spine, causing predominantly back pain with the absence of nerve root irritation or compromise, present a difficult treatment challenge to the average physician. The author suggests that facet joint injections offer a simple, safe, and often dramatically effective means for managing these problems. The historic background and technique are described in detail. The author presents his personal experience with 99 patients receiving a total of 117 facet joint injections in this retrospective, uncontrolled review. Results were classified as excellent in 17%, good in 25%, fair in 9%, mediocre in 4%, and no change in symptoms occurred in 44%. The procedure is recommended for diagnostic and conservative therapy.