Cervical facet syndrome is neck pain coming from the small facet joints of the cervical spine, often referring to the head, shoulders, or upper back. At PHI in Beverly Hills, board-certified physicians Dr. Faisal Lalani and Dr. Nadiv Samimi confirm it with a diagnostic block and treat it with image-guided facet injections and radiofrequency ablation.
When Your Neck Pain Has a Specific Source
Cervical facet syndrome is a recognized cause of chronic neck pain that often gets lost in the broader neck-pain diagnosis. If you have been treated for general neck pain for months or years without lasting relief, your pain may actually be coming from the small joints in your cervical spine called facet joints.
The good news: cervical facet syndrome has one of the clearest diagnostic and treatment pathways in interventional pain medicine. A targeted diagnostic injection confirms the source. If the injection helps but does not last as long as you would like, radiofrequency ablation can extend relief to 6 to 18 months from a single procedure. For patients who fit this diagnosis, treatment outcomes are often more predictable than for many other chronic pain conditions.
What Cervical Facet Joints Are
Your cervical spine has seven vertebrae stacked on top of each other. Between each pair are two small joints at the back called facet joints, which allow your neck to bend, twist, and tilt while providing stability. Like any other joint, they can develop arthritis, become inflamed after injury, or be irritated by ongoing stress, and when this happens they generate the characteristic neck pain pattern of cervical facet syndrome.
The pain often refers to the back of the head, the upper shoulders, or between the shoulder blades, depending on which level is involved. This referred pattern is part of why cervical facet syndrome can be confusing to diagnose. Many patients are surprised to learn that pain at the base of the skull or between the shoulder blades is actually coming from a joint in the middle of their neck.
What Cervical Facet Syndrome Feels Like
Common features include:
- Chronic neck pain that has lasted weeks, months, or years
- Pain that worsens with extension (looking up) or twisting the neck
- Pain that may be one-sided more than the other
- Morning stiffness that improves somewhat with movement
- Pain that refers to the back of the head, upper shoulders, or upper back
- Limited neck range of motion, particularly in extension and rotation
- Pain that does not typically radiate down the arm, which would suggest a pinched nerve instead
- Pain that often develops after whiplash or another neck injury, sometimes years later
If several of these patterns describe your experience, cervical facet involvement is worth evaluating.
How PHI Diagnoses and Treats Cervical Facet Syndrome
The most reliable diagnostic test is a cervical medial branch block, a small injection of local anesthetic near the nerves that supply each facet joint. If your typical neck pain significantly improves in the hours immediately after, the facet joints are confirmed as a primary source. This dual diagnostic-and-therapeutic approach is part of why diagnostic injections are often the first interventional step.
For confirmed cervical facet syndrome, treatment follows a clear sequence. Cervical facet injections are usually first, delivering local anesthetic and corticosteroid into or near the facet joints, with relief lasting weeks to several months. Cervical radiofrequency ablation is the natural next step for patients whose injections confirm the diagnosis but produce shorter-than-desired relief; it uses targeted heat energy to disrupt the small nerves carrying pain signals from the facet joints, providing relief that typically lasts 6 to 18 months and can be repeated when the nerves regenerate. PHI performs every cervical procedure in our surgical suite under image guidance. Whether one or two diagnostic blocks are needed before ablation is decided patient by patient, based on the degree of relief from the first block.
Why PHI for Cervical Facet Syndrome
Two board-certified pain physicians
Dr. Faisal Lalani and Dr. Nadiv Samimi both trained in interventional pain at Cedars-Sinai, with specific expertise in the cervical spine where precision and image guidance are particularly important.
Image-guided technique
Cervical injections and ablations require image guidance and a properly equipped environment. PHI performs every cervical procedure in our surgical suite under fluoroscopy.
Clear diagnostic-to-therapeutic pathway
Cervical facet syndrome has one of the most established pathways in interventional pain. We follow the evidence-based sequence: diagnostic block to confirm the source, then radiofrequency ablation for longer-lasting relief if appropriate.
Diagnostic-to-therapeutic continuity
Your physician performs the diagnostic block, tracks your response, evaluates whether ablation fits next, and performs it when appropriate. This continuity is uncommon at higher-volume practices.
A range of sedation options
From local anesthetic to nitrous oxide, conscious sedation, or deeper sedation, we match the sedation approach to the procedure and your comfort.
Concierge, coordinated care
Single-physician continuity from consultation through treatment and return to activity. Patients receive clear guidance and transparent pricing at consultation.
Frequently Asked Questions
The patterns are different. Cervical facet syndrome typically produces neck pain that worsens with extension and twisting, with referred pain to the head, shoulders, or upper back. A herniated disc more commonly produces radiating pain down the arm, often with numbness or tingling. Many patients have both, and physical examination plus diagnostic injections often clarify which is dominant.
MRI findings do not always correlate with the actual source of pain. Many patients have facet arthritis on imaging that is not the primary cause of their symptoms. A diagnostic injection directly tests whether your specific facet joints are generating your pain, which confirms the diagnosis and changes treatment recommendations for some patients.
For appropriate candidates with positive diagnostic blocks, cervical ablation produces meaningful pain relief lasting 6 to 18 months in most patients. The procedure can be repeated when relief diminishes.
Most patients describe the procedures as briefly uncomfortable rather than painful. Local anesthesia numbs the skin and tissue, and a range of sedation options is available depending on your comfort and the procedure.
Most patients return to most normal activities within 1 to 2 days after a facet injection. Ablation typically requires a few days to a week of restricted activity, with full benefit developing over 2 to 6 weeks as the targeted nerves stop transmitting pain signals. This varies patient to patient and is discussed with your physician.
Chiropractic adjustments work by manually moving joints to address mechanical restrictions. Interventional pain treatments target the specific nerves or joints generating pain through medical procedures. The two approaches address different things and can sometimes complement each other.
Most patients with cervical facet syndrome do not need surgery. The vast majority find meaningful relief through targeted injections and radiofrequency ablation. Surgery is reserved for specific situations.
Insurance coverage and payment options may vary. All pricing is disclosed at consultation.
Yes. PHI regularly treats patients from outside Los Angeles, including Las Vegas, Palm Springs, London, and other international locations.
Treatments We Offer for Cervical Facet Syndrome
PHI offers the established evidence-based treatment pathway for cervical facet syndrome.
- Cervical Facet Injections, diagnostic and therapeutic
- Radiofrequency Ablation, 6 to 18 months of relief from a single procedure
Schedule Your Cervical Facet Consultation
A 60-minute consultation will evaluate whether your neck pain is consistent with cervical facet syndrome, walk through the diagnostic and treatment pathway, and give you a clear plan. Call (310) 856-9488 or book online now.