Chronic neck pain usually has a specific structural source, the facet joints, the discs, or the nerves, underneath the lifestyle factors. At PHI in Beverly Hills, board-certified physicians Dr. Faisal Lalani and Dr. Nadiv Samimi identify that source and treat it with image-guided cervical injections, facet injections, and radiofrequency ablation.
When Your Neck Won’t Stop Hurting
Neck pain is one of the most common chronic pain complaints, and one of the most under-diagnosed. Many patients arrive having been told their neck pain is stress, poor posture, age, or screen time. Often it is some combination of these contributors. But underneath the lifestyle factors, there is usually a specific structural source generating most of the pain, and identifying that source is the most important step in finding meaningful relief.
The neck has multiple structures that can generate pain: the facet joints, the discs, the nerves, and the muscles. Each responds to different treatments. The right approach depends entirely on which structure is actually involved in your specific case.
Where Your Neck Pain Is Coming From
The patterns below describe the most common sources of chronic neck pain.
Pain that worsens when you look up or twist
Pain centered in the neck that worsens when you look up or twist, sometimes with morning stiffness that improves with movement, often suggests cervical facet joint involvement. The pain may refer to the back of the head, upper shoulders, or between the shoulder blades. See our Cervical Facet Syndrome page; treatment options include cervical facet injections and cervical radiofrequency ablation.
Pain that radiates from your neck into your arm
Pain that travels from your neck down the shoulder, arm, or into the hand, often with numbness, tingling, or weakness, usually suggests cervical radiculopathy (a pinched nerve in the neck), commonly from a herniated disc or arthritis. See our Pinched Nerve page; treatment options include cervical epidural steroid injections and selective nerve root blocks.
Pain after an impact injury, or headaches from the neck
Neck pain that developed after a car accident, fall, or impact and has not fully resolved may be persistent whiplash-related pain (see our Whiplash page). Neck pain accompanied by headaches that start from the back of the head or neck may be cervicogenic headache (see our Cervicogenic Headaches page).
When to See Someone
Consider professional evaluation when your neck pain has lasted more than four to six weeks without improvement, when it interferes with sleep, work, or daily activities, when physical therapy or medications have not provided lasting relief, when you have radiating pain, numbness, or weakness in your arms, or when you have headaches alongside your neck pain.
Seek prompt evaluation if you experience severe neck pain following major trauma, sudden significant arm weakness or numbness, loss of bladder or bowel control, neck pain with fever or severe headache, or difficulty walking or balance changes. These can indicate conditions requiring urgent evaluation.
How PHI Approaches Neck Pain
The first step is comprehensive evaluation to identify what is actually causing your pain: a detailed history of what makes it worse or better, an examination with specific tests for facet involvement and nerve compression, review of imaging, and sometimes a diagnostic injection to confirm the source when more than one diagnosis is possible.
Once the source is clear, treatment options include cervical epidural steroid injections for nerve-related neck pain, cervical facet injections for facet-mediated pain (both diagnostic and therapeutic), and cervical radiofrequency ablation for patients whose facet injections confirm the source but produce shorter-than-desired relief, which can extend relief to 6 to 18 months. The cervical spine is a precise area, so PHI performs every cervical procedure in our surgical suite under image guidance. We coordinate with physical therapy and other specialists for patients whose neck pain involves significant muscle, postural, or biomechanical contributors.
Why PHI for Neck Pain
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 cervical technique
Cervical injections without imaging are less accurate and riskier given the proximity of the spinal cord and nerves. PHI performs every cervical procedure in our affiliated surgical suite under fluoroscopic guidance.
Diagnostic-first approach
Many neck pain patients have been treated for the wrong primary diagnosis. We take time to identify what is actually causing your pain before recommending treatment.
Full range of cervical treatments
PHI offers cervical epidurals, facet injections, and radiofrequency ablation, with the right approach matched to your specific diagnosis.
Honest framing
Some neck pain responds well to interventional treatment; some responds better to physical therapy or other approaches. We tell you straightforwardly which category fits your situation.
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 pattern often gives clues. Facet pain typically worsens with neck extension and twisting. Disc-related pain often involves radiating arm symptoms. Muscle pain is usually more diffuse and tied to position or activity. Many patients have combinations. Physical examination plus diagnostic injections can clarify the dominant source.
This is common. Most adults over 40 have some changes on cervical MRI even without neck pain. Many patients have multiple findings, only one of which is generating their symptoms. Diagnostic injections can directly test which specific structure is producing your pain, which often clarifies treatment recommendations.
In most cases yes, often alongside other treatments. Physical therapy works best when paired with treatment of the underlying source. Patients who have done PT for months without improvement often benefit from interventional treatment that addresses inflammation or joint dysfunction PT alone cannot reach.
Most patients with chronic neck pain do not need surgery. The vast majority find meaningful relief through targeted injections, radiofrequency ablation, and other non-surgical approaches. Surgery is reserved for specific situations.
The cervical spine is a precise area with the spinal cord and major nerves in close proximity. Image guidance ensures the medication reaches the intended structure safely. Cervical injections without imaging are less accurate and meaningfully riskier.
This varies by treatment. Cervical injections often produce relief within days to weeks. Radiofrequency ablation produces gradual improvement over several weeks. Your physician will set specific expectations.
Chiropractic adjustments can help some patients with mechanical neck pain. PHI’s interventional approach addresses different mechanisms, the specific nerve or joint sources of pain. Some patients benefit from both, and we do not typically conflict with appropriate chiropractic care for muscle-related contributors.
Insurance coverage and payment options may vary. Please contact our office to discuss your specific plan, available options, and pricing.
Yes. PHI regularly treats patients from outside Los Angeles, including Las Vegas, Palm Springs, London, and other international locations.
Treatments We Offer for Neck Pain
PHI offers the full range of evidence-based treatments for neck pain. Your physician will recommend the right option, or combination, based on the actual source of your pain, your imaging, and your treatment history.
- Cervical Epidural Injections, for nerve-related neck pain
- Cervical Facet Injections, diagnostic and therapeutic for facet-mediated pain
- Radiofrequency Ablation, extends relief to 6 to 18 months
Schedule Your Neck Pain Consultation
A 60-minute consultation will identify the actual source of your neck pain, walk through the treatment options that match it, and give you a clear plan. Call (310) 856-9488 or book online now.