Cervical Facet Injection

A cervical facet injection involves injecting a small amount of local anesthetic (freezing) and an anti-inflammatory steroid into facet joints of the cervical spine to help relieve neck pain from inflammation or arthritis. A bone scan with SPECT/CT may be requested by your doctor to better identify acutely inflamed joints.

These injections typically relieve pain for 3-6 months. If successful, repeat injections can be performed after three months.

HOW DO I PREPARE FOR MY PROCEDURE?

• It is recommended that you do not wear jewelry around your neck or in your ears to your appointment.
• If you have long hair, please bring a hair tie to your appointment to keep your hair secured during the injection.
• If you take insulin to manage your diabetes, please let your booking coordinator know. You may have some juice and a small snack after taking your insulin. Please eat one hour before your appointment.
• IMPORTANT: Please schedule your injection either two weeks before or one week after any vaccination appointment.
• If you are currently taking antibiotics, you will need to wait two weeks after your last dose before having your injection.
• Take all prescribed medications as directed.
• It’s recommended that you have a driver accompany you to this appointment.
• Please arrive 15 minutes before your appointment to allow enough time to check in with reception and fill out a consent form.
• Bring photo identification and your provincial health card.
• Wear comfortable clothes.
• Please do not bring children who require supervision.

WHAT HAPPENS DURING MY PROCEDURE?

• We may provide you with a comfortable clinic gown to change into (depending on the area being treated).
• A team member will explain the consent form, procedure details, and answer any questions.
• We will then escort you to our treatment suite where you will lie on your stomach with your neck flexed and your forehead resting on the table. This is to open the facet joints for easier access with the needle.
• The radiologist will clean the skin and inject a local anesthetic, similar to the freezing you would get at the dentist.
• After the location is confirmed with X-ray guidance, the steroid and freezing will be injected into the joint using a thin needle.
• You may experience mild discomfort, so please have someone accompany you on the day of your test. It may be more convenient to have someone drive you home.
• You will be assessed post-injection by our team and, if there are no concerns, you will be free to leave.

POST-PROCEDURE INSTRUCTIONS

• First 24 hours:
  • Keep the treatment area clean. Leave the Band-Aid on. Do not shower.
  • If possible, please avoid anti-inflammatory medication for 24 hours (i.e., ibuprofen/Advil).
  • A feeling of heaviness, numbness, or tingling in one or both arms is normal and could last for 4-6 hours.
• First 48 hours:
  • Avoid bathtubs, hot tubs, and pools.
  • Avoid strenuous activities and lifting for 3-5 days.
• After one week: You may resume strenuous activity, lifting, and physiotherapy. Be mindful of your pain and stop if it hurts too much. Notify your physiotherapist that you have had this injection so they can modify your exercises if necessary.
• Watch for infection: If you develop worsening pain, skin redness at the site of injection, or a temperature greater than 38.5°C, please proceed to an urgent care or emergency centre.
• Watch for symptoms of bleeding around the spine: If you have intense neck/shoulder pain that comes quickly and travels down one or both arms and continues to intensify, please call 911 or go to an emergency room right away.
• If you have pain or other symptoms beyond 48 hours after your injection, this is a normal reaction. You may apply heat and ice to the treatment area. If you have any questions, please email us at paintherapy@radiology.ca during business hours.
• Diabetics: Note that cortisone can cause a temporary increase in blood sugar. Please monitor your blood sugar closely and if you have any concerns, consult with your doctor.

WHEN WILL I SEE RESULTS?

• After your injection, the freezing may last for a few hours. Your symptoms may return until the steroid takes effect in two weeks. Please track your symptom response to share with your physician.
• These injections typically provide at least three months of symptom relief. If an injection does not help relieve your symptoms, then you may need further evaluation by your referring doctor for another cause of your symptoms.
• Please consult with your doctor regarding your results and any follow up exams or questions.

HOW MUCH WILL IT COST?

This exam is covered under your Alberta Health Care Plan. It is not currently offered at our Saskatchewan clinics.