Cervical Facet Injections

Indications:

The number one cause of mechanical neck pain is arthritis in the joints of your neck. This condition is typically not fixed by surgery. This injection is used to treat this arthritis. This injection can also be helpful for patients who have pain from a whiplash type injury. Some headaches can be caused from these joints in the neck where this injection can help to alleviate this. Other pains that may be coming from the arthritis in your neck is upper back and/or shoulder pain. This is most beneficial for neck pain that can radiate to your shoulders and upper back but usually not for pain that travels past the elbows.

Pain typically comes from the joints that become irritated and subsequently swollen (inflamed). By placing a steroid, which is a strong Anti-inflammatory, into the inflamed joint, this decreases the swelling which thereby decreases your pain.

 
Contraindications/Reasons why you may not have your injection today:

• Bleeding disorders/low platelet counts
• Medications that thin your blood (please review this section)
• Current infection
• No driver
• Your symptoms have changed and/or improved
• Patient refusal
• Procedure not approved by your insurance
• Poorly controlled high blood pressure that may be giving you symptoms
• Poorly controlled diabetes
• Certain types of glaucoma
• Poorly controlled bipolar disorder
• Allergies to the any of the medications that is being used

 
Potential side effects/risks of the procedure:

• Increased pain
• Numbness in upper extremities that is short lived
• Infection
• Bleeding
• Allergic reaction to medications used to clean your skin and/or medications injected
• Cramping in lower extremities
• Mood changes
• Flushed face/extremities
• Headaches
• Worsening of high blood pressure
• Increasing of blood sugars if you have diabetes
• Water retention
• Chronic steroids can cause weight gain
• Seizures
• Stroke
• Nerve and/or spinal cord injury

 
Procedure: 
During the procedure, you will be lying on your stomach.  An x-ray machine is used to locate the specific level of the spine which is believed to be causing your pain based upon where you hurt in your neck.  After your skin is cleaned with an antiseptic solution, normally betadine unless you are allergic, a series of x-rays will be taken to guide the needle placement.  The skin is localized with a local anesthetic which is typically the most painful part of the procedure as this medicine has a tendency to burn when it is injected.  After this point, you should only feel pressure.  If anything is too painful for you, please tell your physician, as more numbing medicine can be given at any time.  When the needle enters into the joint, a mixture of local anesthetic and steroid is slowly injected. You may experience increased pressure in your neck region which is normal.  However, if at any time the pain is too intense, please tell your physician to slow down your injection.  After the medication is injected, the needle is removed and the procedure is completed.

Typical length of the procedure: 
5 minutes.  Expect to be at the clinic no more than 15 minutes after you have been checked in by the medical assistant into the preoperative area.  If this is your first time at our clinic, you will likely be at the clinic for at least one hour.  Please plan accordingly.

How long do you expect pain relief: 
It is difficult to determine how long and how much pain relief you may experience.  It varies depending on multiple factors.  Some patients do not gain any relief from the procedure and some may have permanent pain relief.  If you experience relief right after this procedure, this can be diagnostic that your pain is coming from the specific joint(s) that were injected today.