See how it is done
The cervical facet joints are the small paired joints at the back of your neck that let you nod, turn, and tilt your head. Arthritis, age-related wear, or a whiplash injury can leave them inflamed — producing a deep, aching neck pain that often spreads into the shoulders or up into the back of the head, and that tends to be worse when you look up or hold your head in one position.
A cervical facet joint injection places a small dose of long-acting corticosteroid directly into the affected joint(s) under live X-ray (fluoroscopy) guidance. The imaging step matters: the cervical facets are small and sit close to important structures, so we confirm needle position with contrast before injecting.
The injection works both ways — if your usual neck pain settles, it confirms the facet joints are the source, and the steroid then calms the inflammation for typically 4 to 12 weeks. We usually pair it with physiotherapy so the relief becomes a window to rebuild neck and postural strength. When the injection helps but the benefit is short-lived, cervical medial branch block followed by radiofrequency ablation is the natural next step.
What this treats
- cervical facet syndrome
- cervical facet arthropathy
- post-whiplash neck pain
- axial neck pain
Conditions this treats
Common diagnoses we use this procedure for. Tap one to read more.
Before, during, and after — what to do
Before your appointment
Eat a normal meal before your appointment — there is no fasting required for most injections. Take your usual medications unless we have specifically asked you not to. If you take a blood thinner (aspirin, warfarin, clopidogrel, apixaban, rivaroxaban, etc.), tell us in advance — we may need to adjust the timing. Bring your OHIP card and any imaging reports we asked for.
On the day
Wear loose, comfortable clothing — easy to roll up sleeves or pant legs, easy to lie face-down on the table. Plan to be at the clinic about 45 minutes total. You can drive yourself unless we told you otherwise. If you are anxious about the procedure, tell us — we will walk you through every step.
After the procedure
You may feel some soreness at the injection site for 1–3 days. Ice helps; so does Tylenol or ibuprofen if you can take it. Avoid heavy lifting or vigorous exercise for 24 hours, then resume normal activity as comfort allows. The therapeutic effect of the injection usually starts within a few days and reaches full strength by 2 weeks.
When to call us: Call us right away — or go to the nearest emergency department — if you develop a high fever, severe new pain, redness or swelling at the injection site, weakness in a limb, or loss of bladder or bowel control. These are rare but worth knowing.
What happens on the day
We use live fluoroscopy to see exactly where the needle is going. The procedure itself takes about 15 minutes, plus a little time to get you positioned and a short rest afterwards. Most people feel relief lasting 4–12 weeks.