Background: Lumbar facet joints have been implicated as the source of chronic pain in 15% to 45% of patients with chronic low back pain. Lumbar facet joint block (FJB) has been described in the alleviation of chronic low back pain of facet joint origin. Objective: To determine the difference of outcome in lower back pain (LBP) patients with and without Modic changes treated with therapeutic imaging-guided lumbar facet joint injections and the role of those techniques in the future of accurate diagnosis and proper management for such patients.  Patients and methods: This study included 12 patients complaining of persisting LBP, 6 of them had Modic changes and 6 cases without, confirmed by lumbar spine MRI at Neurosurgery Department, Zagazig University Hospital. They were managed by lumbar facet joint block. They were followed up at 6 and 12 weeks after procedure for Visual Analogue Scale (VAS) as well as Oswestry Disability Index (ODI). Results: There was statistically non-significant relation between the studied groups regarding ODI pre or 6 weeks post-injection. While there was statistically significant difference between groups regarding ODI 12 weeks postoperatively, there was significant change in ODI over times.There was statistically non-significant relation between the studied groups regarding VAS pre or 6 weeks post-injection. While there was statistically significant difference between groups regarding VAS 12 weeks postoperatively. Conclusion: The effectiveness of therapeutic lumbar facet joint injections is not altered by the presence or absence of Modic. There were no reported significant differences between study groups for the primary outcome at 6 weeks post-injection.