Cortisone Shots for Neck Pain

Inclusion Criteria:

• at least 18 years old

• Patient who will be getting a neck cortisone shot for pain that has been there forat least 4 weeks

• A specific MRI finding (increased Short Tau Inversion Recovery signal) around 1 ormore of the joints in the neck

Exclusion Criteria:

• Those receiving disability, worker's compensation, or are involved in litigationrelated to their pain.

• Those unable to read English and complete the assessment instruments.

• Those unable to attend follow up appointments

• The patient is incarcerated.

• Grade 2 or greater spondylolisthesis at the involved or adjacent segments.

• History of prior posterior cervical surgery. Anterior cervical surgery is not anexclusion criteria.

• Progressive motor deficit, and/or clinical signs of myelopathy.

• Prior neck cortisone shots within the past 6 months.

• Possible pregnancy or other reason that precludes the use of fluoroscopy.

• Allergy to contrast media or local anesthetics.

• BMI>35.

• Systemic inflammatory arthritis (e.g., rheumatoid arthritis, ankylosing spondylitis,lupus).

• Active infection or treatment of infection with antibiotics within the past 7 days.

• Chronic widespread pain or somatoform disorder (e.g. fibromyalgia).

• Addictive behavior, severe clinical depression, or psychotic features.