Cervical Facet Injections
Relief From Neck Pain Near You in New Jersey
Neck pain that stiffens in the morning, worsens when you turn your head, or sends a dull ache into the base of your skull or upper back often comes from the facet joints of your cervical spine. These small but critical joints are one of the most overlooked causes of chronic neck pain, but they are also one of the most treatable.
Key Takeaways
- Cervical facet joints are small joints at the back of the neck that can become inflamed or arthritic, causing significant pain, stiffness, and referred discomfort in the head, shoulders, or upper back.
- A cervical facet joint injection delivers steroid medication directly into the affected joint to reduce inflammation and relieve pain.
- This procedure is done under fluoroscopic guidance and takes about 15 to 30 minutes.
What Do Cervical Facet Joint Injections Treat?
Cervical facet joint injections can be used to treat conditions ranging from arthritis to upper back pain. Your cervical spine consists of the seven vertebrae that make up your neck. Instead of being a single solid column, it’s a series of stacked bones connected by discs in the front and small paired joints in the back. Those back joints are called facet joints, and they guide how your neck moves, limit over-rotation, and bear a portion of the load every time you nod, tilt, or turn your head.
Like any joint in the body, facet joints can break down. When they do, it results in a distinctive neck pain that tends to respond well to targeted treatment. Cervical facet joint injections can treat:
Neck Arthritis and Facet Pain
- Cervical osteoarthritis: Sometimes called spondylosis, this is a thinning of the cartilage within the facet joints that causes bone-on-bone friction, inflammation, and joint enlargement.
- Whiplash and prior neck injuries: Trauma to the neck, even from injuries that happened years ago, can accelerate facet joint degeneration and trigger chronic inflammation.
- Repetitive strain: Prolonged forward head posture, heavy physical work, or sports that repeatedly stress the cervical spine can wear down facet joints faster than normal aging.
Headache and Upper Back Referral Patterns
How Do Cervical Facet Joint Injections Work?
The injection contains both a corticosteroid and a local anesthetic:
- Corticosteroid: This potent anti-inflammatory agent works by suppressing the inflammatory response inside the joint. As a result, swollen tissues calm down, the joint has more room, and pain signals decrease.
- Local anesthetic: This temporary medication produces rapid numbness, which tells Dr. Kurdali whether that specific joint is the source of your pain. It also makes the injection process more comfortable.
Cervical facet joints are small, closely spaced, and are in a delicate part of the spine. Dr. Kurdali performs this procedure under fluoroscopy, which is a continuous, real-time X-ray that displays your cervical anatomy on a screen as he advances the needle. Additionally, before he injects the medication, he uses a small amount of contrast dye to confirm that the needle is in the right place.
What Should I Expect Before, During, and After Treatment?
During the Procedure
After the Procedure
Before you leave, Dr. Kurdali will also provide you with specific after-care instructions, which often include:
- Activity: Rest on the day of the procedure. You can resume normal light activities the following day.
- Ice and heat: Apply ice to the injection site for the first 24 hours. Avoid soaking in baths, hot tubs, or swimming pools for 24 hours.
- Pain diary: Dr. Kurdali may ask you to track your pain levels in the days following the injection. This information helps him determine whether you need further treatment.
- Follow-up: We’ll schedule a follow-up visit for two to four weeks after your injection to review your response and discuss next steps.
Results and Recovery after a Cervical Facet Joint Injection
The local anesthetic begins working within minutes. If your pain drops noticeably in the first one to three hours, that means the targeted joint was most likely the source of your pain. While you may start to feel less pain almost immediately, it may take three to seven days for you to notice significant improvement.
For many patients, the injection is the beginning of a more active rehabilitation phase, not the end of treatment. Once your pain is better under control, physical therapy is the next step. A physical therapist can work on:
- Restoring cervical range of motion that has been limited by pain
- Strengthening the deep neck flexors and stabilizing the muscles that support the facet joints
- Correcting forward head posture
They will also help you work on your posture. Every time your head shifts forward, you place more weight on your cervical joints, which can cause pain and stiffness. This problem is exacerbated when you spend extended periods staring at screens or phones or sitting at desks. Addressing your posture is one of the most important things you can do to protect your neck long term.
What Are the Risks and Side Effects of Cervical Facet Joint Injections?
- Soreness or bruising at the injection site
- A temporary increase in neck pain or stiffness in the first 24 to 48 hours
- Mild headache
- Facial flushing, redness, or warmth in the face or neck
- Temporary blood sugar elevation, especially in diabetic patients
- Infection
- Minor bleeding at the injection site
- Dural puncture
- Nerve irritation, temporary tingling, or soreness that doesn’t go away on its own
- Allergic reaction
Are There Alternative Treatments?
Conservative Options
- Structured physical therapy focused on cervical mobility, deep neck strengthening, and postural retraining
- Nonsteroidal anti-inflammatory medications (NSAIDs) or short-course oral steroids to manage acute flares
- Topical treatments, such as diclofenac gel, applied directly to the painful area
- Activity modifications for patients whose symptoms are worsened by working at a desk