Overview
Cervical facet joint block is a targeted treatment used when the small joints at the back of the neck are contributing to pain. These facet joints help guide neck movement and maintain spinal stability. When they become inflamed or irritated, often because of wear and tear, posture related strain, or injury, they may cause localised neck pain, stiffness, and discomfort that can spread into the shoulders or upper back.
A cervical facet joint block delivers medication directly to the affected joints or to the small nerves that supply them. The aim is to reduce irritation, calm pain signals, and support improved movement. In some cases, the procedure also helps confirm whether the facet joints are the main source of symptoms.
Who this treatment helps
Cervical facet joint block may be considered for people with:
- Localised neck pain made worse by turning or bending
- Stiffness or aching around the back of the neck
- Pain following whiplash or repetitive strain
- Discomfort that spreads into the shoulders or upper back
- Symptoms linked to facet joint irritation on examination or imaging
- Persistent pain despite medication or physiotherapy
A consultation is required to confirm suitability and rule out other causes of neck pain.
What is a cervical facet joint block
A cervical facet joint block involves placing a small amount of local anaesthetic, sometimes combined with steroid medication, into or around the facet joints. In many cases, the medication is placed near the medial branch nerves, which are small nerves that carry pain signals from the joints.
Imaging guidance such as fluoroscopy or ultrasound may be used to support accurate needle placement and improve safety.
The procedure can be both diagnostic and therapeutic:
- Diagnostic: helps determine whether the facet joints are the source of pain
- Therapeutic: may reduce inflammation and ease symptoms
If the block provides good short term relief, radiofrequency treatment may be discussed as a longer lasting option.
What to expect during the procedure
- Your consultant reviews the treatment plan and answers any final questions
- You lie comfortably on the procedure table
- The skin over the neck is cleaned and numbed with local anaesthetic
- A fine needle is guided to the facet joint or medial branch nerve, often using imaging guidance
- A small amount of medication is injected
- You rest briefly before going home
The procedure usually takes around 10 to 20 minutes.
After the procedure
- Mild soreness at the injection site is common
- Temporary numbness or warmth in the neck may occur
- Some people notice improvement within hours, while others may take a few days
- Normal activities can usually be resumed the same day, avoiding strenuous exercise for 24 hours
- Your consultant may recommend physiotherapy or follow up treatment depending on your response
Benefits
- May reduce neck pain linked to facet joint irritation
- Helps identify whether the facet joints are the source of symptoms
- Can improve mobility and comfort
- May reduce reliance on medication
- Minimally invasive with a short recovery time
- Can guide future treatment planning, including radiofrequency options
Possible risks and side effects
Cervical facet joint blocks are generally safe when performed by experienced clinicians, but all procedures carry some risk.
- Temporary numbness or mild weakness
- Local soreness or bruising
- Light headedness
- Infection, which is rare
- Bleeding, uncommon
Your consultant will discuss individual risks during your assessment.
When to consider other options
If symptoms persist or the block provides limited benefit, your consultant may discuss other treatments such as cervical epidural steroid injection, trigger point injection, medial branch radiofrequency treatment, medication review, physiotherapy, or combined approaches for more complex neck pain.
Safety note
Please inform your consultant if you take blood thinning medication, have allergies, diabetes, active infection, are pregnant, or have had previous reactions to local anaesthetic. You may need someone to drive you home depending on how you feel after the procedure.
Arrange a consultation to discuss whether a cervical facet joint block may be appropriate for your symptoms.
You can also explore our neck pain and whiplash treatments, view all pain treatments, or learn more about our pain management services.