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Cervical Injections
Cervical Facet Joint Injection
An in-depth, evidence-based explanation of the cervical facet joint injection — an image-guided injection into a small joint of the neck to diagnose and treat facet-related neck pain.
The facet joints are the small paired joints at the back of the spine that guide and steady movement. In the neck, these joints can become a source of pain, particularly after whiplash or with age-related wear. A cervical facet joint injection places local anaesthetic, sometimes with steroid, directly into or around one of these joints under image guidance, both to test whether the joint is responsible for the pain and to try to relieve it. This page explains what the injection involves, when it can be used, and what the evidence shows.
For information only — not medical advice. The content on this page is patient education to help you understand a condition or treatment. It is not a substitute for personalised assessment by a qualified clinician. Always consult your doctor or specialist about your own symptoms, diagnosis, and treatment decisions.
What a cervical facet joint injection is
A cervical facet joint injection is delivered under X-ray guidance to ensure the needle reaches the correct small joint. Local anaesthetic is injected into or around the joint, often with a small dose of steroid. The local anaesthetic can quickly numb the joint, helping to confirm whether it is the source of pain, while the steroid aims to reduce inflammation for a longer period. Because these joints are small and close to important structures, accurate image guidance is essential.
When it can be used
This injection can be used when neck pain is thought to arise from the facet joints — for example pain that is worse with extending or turning the neck, or that follows a whiplash-type injury, without significant nerve compression. It has a diagnostic role, helping to confirm the joint as the pain source, and a therapeutic role, providing a period of relief. Where a facet joint is confirmed as the culprit and relief is only temporary, it can also help guide a decision about longer-lasting treatment such as radiofrequency denervation.
What the evidence shows
The evidence is moderate and should be presented honestly. Systematic reviews of cervical facet joint interventions find that these injections can provide diagnostic information and short-term relief for facet-mediated neck pain, though the strength of evidence for lasting therapeutic benefit from intra-articular steroid alone is limited. Their main value is often as part of a diagnostic pathway — confirming the facet joints as the source before proceeding to medial branch blocks and, if appropriate, radiofrequency treatment. The balanced view is that a facet injection is a useful, targeted step rather than a definitive cure on its own.
What to expect
The injection is a day-case procedure performed with image guidance. The immediate response to the local anaesthetic is informative — noting how much the usual pain settles helps confirm the diagnosis — while any steroid effect develops over subsequent days. Depending on the response, the next step may be continued conservative care, a repeat procedure, or a diagnostic medial branch block to plan longer-lasting treatment. Risks are discussed beforehand. Whether this injection is appropriate depends on the individual and is decided with the treating team.
Disclaimer. The information provided on this page is intended for educational purposes only and should not be considered personalised medical advice. Every patient is different, and treatment options, risks, expected recovery and outcomes depend upon an individual's diagnosis, injury pattern, bone health, general health and personal circumstances. Decisions regarding treatment should always be made following consultation with your treating spinal surgeon or healthcare professional.
Evidence & further reading
- —Falco FJ, et al. Systematic review of the therapeutic effectiveness of cervical facet joint interventions: an update. Pain Physician 2012. (PMID 23159978)
- —Falco FJ, et al. An updated review of the diagnostic utility of cervical facet joint injections. Pain Physician 2012. (PMID 23159977)
- —Farrell S, et al. Glucocorticoid facet joint injection for chronic back or neck pain. Cochrane Database Syst Rev 2024. (PMID 39569679)
- —Viva MG, et al. Efficacy and accuracy of ultrasound-guided injections in cervical facet joint syndrome: a systematic review. J Clin Med 2024. (PMID 39274505)
- —Sehgal N, et al. Systematic review of diagnostic utility of facet joint injections in chronic spinal pain: an update. Pain Physician 2007. (PMID 17256031)
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