Resolve Pain logo

Cervical facet joint pain

Neck pain, often associated with headaches and shoulder pain, is a very common condition in Australia. Fortunately,most people who experience neck pain improve with exercise, massage, and rest. However, there is a group ofpeople who experience chronic pain – pain that lasts >3 months. Exact numbers are unclear, but some studies have suggested that neck pain lasting more than 6 months occurs in ~15% of people (1).

Cervical facet anatomy

Neck pain can be limiting and frustrating for us as we need to use our necks for many activities we perform. It can affect our ability to work, our mood and our quality of life. Associated headaches and shoulder tension is also very unhelpful. While there are many possible causes of neck pain and headaches, one possible cause for some people are theircervical facet joints. These small joints, on the back of every neck vertebra (neck bone) can be a major source of pain. They can be injured by falls, whiplash, car accidents, and even sometimes we cannot recall what may have triggered or caused injury to our neck.

Normal cervical facets help support the load of our head and allow rotation and movement. Unfortunately, if these facet joints are inflamed, irritated, or have arthritis, they can cause pain in multiple areas (as shown below). Our brain is not very good at having an ‘internal map’ of where our joints and organs are. Therefore,we experience our pain sensation at the skin in different spots as our brain tries to ‘tell us’ what is wrong!

If you experience neck pain, the first things to do are to perform gentle stretching, use simple medications such asparacetamol and possibly anti-inflammatory creams (e.g., nurofen gel) and try and adjust our lives to avoid flaringour pain (such as looking at our work position or driving positions). Physiotherapists and occupational therapists canbe extremely helpful, and this may at times help us completely manage our pain. Unfortunately, at times people’s  pain is so severe that it limits them being able to perform the exercises and rehabilitation to improve neck musculature, flexibility and strength needed to help reduce neck pain long term.

Diagnosing facet pain in the neck is difficult. While your health provider will perform examination techniques to try and localise which facets may be involved, there are no scientifically proven examination or movement tests toconfirm facet joint pain. The main way to confirm whether someone is experiencing facet joint pain is to put a small numbing injection ontothe facet joint to see if this can take away the pain. While temporary, it is a TEST to find out if the facet is  contributing; and by how much.

If this diagnostic test takes away your neck pain/headache/shoulder ache, then we can perform further procedures such as pulsed or heat radiofrequency ablation to offer reduced pain from these facets for up to a year. The main benefit is to offer a window of opportunity for you to perform rehabilitation to stretch and strengthen your neck so that when the procedure wears off, the pain does not return fully. Fortunately, the radiofrequency ablation can be performed ongoing if required and many people prefer a procedure once or twice a year to experiencing significant discomfort or having to take medications every day.

If these procedures have been unsuccessful, or you have ongoing pain despite everything you have tried, there are neurostimulator implants that can be placed either just below the skin or into the epidural space in the neck which can be very helpful to reduce your pain ongoing. Your doctor may discuss these with you if they thought you were suitable. Further information on these is also below. If you would like any further information on these procedural options or would like to have a further appointment with our doctors, nurses or allied health practitioners, then please don’t hesitate to call and we would like to help assist to strengthen your resolve and make your life less about pain.

Information sheet on Neck Pain - Better Health Network

Click here for PDF printable copy← Back to resources

Talk to us today about how we can help you
on your journey to Resolve Pain.