Cervical Facet Injection

The facet joint is a very small (thumbnail-size) joint that sits in pairs between each bone in your spine. They connect the vertebrae and help guide your spine each time you move. The cervical facet joints are located in the neck area with a total of seven vertebrae. 

Facet joints, in general, are found on both sides of the spine. To simplify their identification and treatment, they’re named based on the vertebrae they connect and the side that they sit on. For example, the right C2-3 facet joint joins together the second and third vertebrae on the right side.

If a cervical facet joint is injured, it can cause pain. The level of pain you feel may vary depending on several individual factors and can range from mild, like muscle tension, to severe. There are two components of the cervical facet joint that may be injured: the cartilage inside of the joint or the connecting ligaments surrounding the joint. 

The pain you feel will generally be concentrated in the area where the facet joint sits. Cervical facet pain can occur anywhere from your head to your lower shoulder blade.

If you feel pain in one or more of the areas listed when you turn your head or neck and it goes on for more than two months, it may be cervical facet pain. X-rays and MRIs are not always effective in showing whether a facet joint is the root of your pain. This is one of the reasons why we use cervical facet injections. 

During a cervical facet injection, an anesthetic and steroid are injected into one or more of your cervical facet joints. This process can be used both to diagnose and to treat your cervical facet joint pain. A local anesthetic and anti-inflammatory corticosteroid may be injected to see if they temporarily reduce or eliminate your pain. If they do reduce your pain and increase your range of motion, it can tell the doctor which facet joint is causing your pain.

This procedure is a relatively simple one. Your doctor will insert a small needle directly into the affected facet joint. A highly specific type of x-ray (fluoroscopy) will be used to help the doctor properly position the needle, ensuring your safety and treatment efficacy. As an extra precaution, a medical dye will also be injected into the area to make sure the needle is in the correct spot. Once your doctor is positive that the needle is in the correct place, the medicine will be injected.

After your injection is complete, you’ll be asked to stay for monitoring for up to 30 minutes. Once it’s time to send you home, our staff will provide you with discharge instructions and a pain diary to track your progress. It’s important to be diligent about tracking your pain in the diary so we know how well the injection is working for you. 

You can begin moving your neck in the ways that were painful before the injection to see if the pain is still there, but be careful not to overdo it. Try to be cautious for the remainder of the day and check with your doctor if you plan on returning to work the following day. Many patients report feeling immediate pain relief and numbness in the neck for a while after the injection. This may indicate that the medicine has reached the right area. 

It’s also possible for your pain to return after a short period or to become a bit worse for the day or two following your injection. This can be caused by irritation from the needle or the corticosteroid itself. Corticosteroids usually take two or three days to begin working, but it can also take up to a week, so be patient and call our office with any concerns. 

The extent and duration of your pain relief may depend on certain individual factors, like the amount of inflammation and pain you experienced, or the number of areas involved. We may find that coexisting factors are responsible for your pain or that you need further treatments, so it’s important for you to keep track of everything in your pain diary. This helps us provide you with the most effective, efficient, and personalized care possible. 

Often, an injection can bring several weeks or months of pain relief before further treatment is needed. Other times, one injection can bring long-term pain relief. We see this being the case for many patients without underlying bone or joint problems. If your pain is caused by an injury to more than one area, only some of your symptoms may be helped by the first injection. We will reevaluate your needs as you progress.