I have mild to moderate facet joint hypertrophy at l1/s1 worse on right side. cortisone & nerve block injections have not worked pain is getting worse?

Maybe this is just : Not the source or only source of your symptoms. Facet joint pain at this side and level is typically localized pain that may refer to buttock & groin worse with back extension &with prolonged sitting & standing . Facet joint issues account for about 20% of primary cause of back pain so see a spine surgeon to make sure this is your problem & to see if other treatment may be in order.

Facet Arthropathy: Facet joint dysfunction often comes from damage to the supporting ligaments, causing too much movement of the joint - leading to hypertrophy/arthropathy on imaging studies, such as mri, and secondary pain issues - such as reflexive muscle spasms, and pain referral patterns: which for the l5-s1 facet joint/capsule/ligaments will be into the buttock, hip, groin, lateral thigh, knee and calf.

Platelet Rich Plasma: PRP is an offered treatment that has shown good success however is considered experimental at this time. The basic theory is it helps to strengthen the ligaments around the facet joint using your own platelets/growth factors and therefore reducing stress on the joint by tightening them up. As far as I know its safer than steroid injection. Pretty cool stuff. Check out regenexx.com