Patients who are struggling with pain from facet joints in the cervical spine may be advised to get facet injections in the neck. This refers to when an injection composed of an anesthetic, like lidocaine, and a steroid, like cortisone, is injected into a facet joint in a patient’s neck. Facet joints are the joints that allow for movement within the spine. Healthy facet joints are lined with cartilage that allows this motion to be smooth and painless. Due to the immense stress our spines endure on a daily basis, however, this cartilage can wear down over time, leaving the bones in the facet joints to rub against each other without any protection. When this occurs, nerve endings in the joint become irritated and an individual will likely experience pain and inflammation within the facet joints, as well as stiffness and a limited range of motion.

What do facet injections do?

Facet injections in the neck have two goals. They are to:

• Diagnose the cause of the patient’s pain. Because a number of different spine conditions can result in pain and stiffness, it is often not immediately clear if and when a facet joint is the source of a patient’s symptoms. By injecting numbing medication into a specific facet joint in the cervical region of the spine, however, a physician can confirm whether the joint is a source of pain, depending on whether the patient experiences immediate relief following the injection.
• Provide the patient with meaningful pain relief. In addition to lidocaine or another numbing medication, facet injections also include cortisone, a steroid that continues to work after the effects of the lidocaine have worn off. The cortisone can help to reduce inflammation in the joint, providing the patient with more meaningful pain relief.

How is a facet injection administered?

Getting facet injections in the neck is a relatively simple process. While the injection itself will only take a few minutes, the entire process from start to finish typically takes somewhere between 15 to 30 minutes. The patient will begin by lying face down on a table. The physician performing the procedure will cleanse the area of the skin where the injection will be given and will then administer a shot to numb the area. He or she will then use fluoroscopy, or X-ray guidance, to guide a thin needle into the affected facet joint and then inject contract dye to ensure it is in the right location. Once the needle is in place, the physician will administer the facet injection.