Inclusion Criteria:  • Continuous or intermittent gradually progressive back pain for more than 3 months not significantly improving on medical treatment and/or physical modalities.  Patients age between 20 and 40 years. Local / paraspinal pain or tenderness with or without radiation to buttock , groin or thigh. Increase of pain on extension , rotation or lateral bending . MRI detected synovitis of the facet joint as defined and graded by Czervionke and Fenton, 2008.  Exclusion Criteria:  • Acute low back trauma, fractures, malignancies and inflammatory diseases.  Pain score of < 4 at rest on visual analog scale. Radicular neurologic complaints. X-ray findings of long standing facet joint disease as; marked joint space narrowing, subchondral sclerosis or bone deformity/ sponylolithesis. Evident disc herniation by MRI. Prior surgery on the spine. Prior interventional treatment on lumbar facet joints Known hypersenstivity to local anesthesia, corticosteroid, contrast medium or blood derivatives. Local or systemic infection or spinal infection. Uncorrectable coagulopathy Diabetes Mellitus Pregnancy