The atlanto-axial joint is at the top of the cervical vertebrae in the upper neck area. Problems within this joint may result in scalp tenderness, neck pain and headaches. They may be the result of an injury to either the cartilage in the joint or its surrounding tissues. A diagnostic axial injection may be performed to determine the cause of pain in the region.
The injection is a combination of local anesthetic and corticosteroid. The anesthetic provides immediate relief from pain, while the corticosteroid works to decrease inflammation and offer longer-term pain reduction. If the axial injection is effective in relieving pain and increasing motion in the joint, it can be used as a treatment method.
Candidates for Axial Injections
Patients who have chronic upper neck pain or headaches may be experiencing atlanto-axial joint pain. X-rays or MRI scans may not be able to identify the pain as being atlanto-axial joint pain, which is why the injection can be valuable as a diagnostic tool.
The Axial Injection Procedure
The procedure takes about 30 minutes. Local anesthesia is used for axial injections. Once the anesthetic has numbed the patient's skin, an imaging technique known as fluoroscopy will be used to insert a small needle into the spine near the axial joint. The medication is injected as soon as the needle is positioned properly. The patient is monitored for about 30 minutes after the procedure and sent home to rest. The patient can typically resume all normal activity the day after the procedure.
Results of the Axial Injection
There may be pain at the injection site from the needle. That pain is temporary and should disappear after a couple of days. Some patients experience permanent relief from their axial pain, with no further injections necessary. Others may experience relief for only a few weeks or months, requiring additional treatment.