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An Atlanto-Axial joint injection is an outpatient nonsurgical procedure for treating and diagnosing chronic upper neck pain and headache.

A patient may experience upper neck pain which may be acute or chronic. This pain causes headaches and makes the patient unable to easily turn the neck in any direction. The AA injection is an injection for treating chronic upper neck pain.

The injection includes the combination of a corticosteroid, which is used as an anti-inflammation and an anesthetic, used as a numbing agent. The medication is injected into the joint where the pain is and used to numb the pain.

What is Atlanto-Axial (AA) joint

The bones of the neck and connected downwards to the spine. Each circular bone is known as vertebrae. The joint connects each vertebra with each other. The purpose of the joint is to help guide your neck and spine when you turn or look at different directions while moving.

The bones or vertebrae that are in the neck make up the cervical region. The cervical region contains seven vertebrae. Each vertebra is connected with another by a joint. The first cervical vertebra is known as Atlas while the second cervical vertebra is known as the Axis.

The joint that connects the first upper vertebrae with the second vertebrae is known as Atlanto-Axial (AA) joint or C1-2 joint. The AA joint is a complex joint that is made up of three synovial joints and it is responsible for a major part of the rotation of the neck.

What is AA joint pain?

In the event that the AA joint is injured or inflamed, you may feel pain or muscle strain. Pain may be mild or severe depending on the severity of the injury.

AA joint can go through cervical trauma as a result of degenerative joint disease. This can cause severe pain. The cartilage inside the joint may be injured or the connecting ligaments can as well be injured. These conditions will lead to pain. Pains usually occur at the upper neck region and may lead to headaches.

Diagnosing of AA joint pain

Patients with AA joint pain will feel pains at their upper neck region and may experience regular headaches. AA joint pain can be diagnosed using imaging scans such as x-ray, MRI, and CT scan. However, the joint responsible for causing the pain may not be known by imaging scan, hence an AA injection may be used to ascertain the joint causing the pain.

What is an Atlanto-Axial injection?

An Atlanto-Axial joint injection contains a corticosteroid and a local anesthetic. The corticosteroid is an anti-inflammatory medication while the anesthetic is a numbing agent. The corticosteroid helps to reduce or prevent inflammation while the anesthetic helps to numb the pain.

An Atlanto-Axial joint injection is used as both diagnostic and therapeutic treatment. When the joint is being injected with the medication and the patient stops to feel the pain, the doctor will then know the joint that is causing the pain.

Who is the ideal candidate for AA joint injection?

If you feel pain at your upper neck and regular headaches, you may be experiencing AA joint pain, hence you are an ideal candidate for the Atlanto-Axial joint injection treatment.

If you have any medical conditions or you are on any medication, it is important that you inform your doctor before undergoing the treatment.

How the procedure is done?

You will be made to lie down on a procedure table with you facing downwards. The doctor will thoroughly clean the skin around the injection site and apply a local anesthetic to reduce pain and irritation.

The doctor will then insert a tiny needle into the Atlanto-Axial joint with the aid of a fluoroscope. The fluoroscope is connected to a monitor and the doctor is able to see the inside of the neck on the monitor. A contrast dye may be injected so that the doctor can see clearly the location of the needle.

When the doctor is sure that the needle is at the right spot, the corticosteroid medication and the local anesthetic are injected into the joint. The doctor will then slowly withdraw and take out the needle. The procedure takes about 20-30 minutes to complete.

After the Procedure

After the injection has been administered, you will be taken to a recovery room where you will be monitored for about 30 minutes. You will be given some set of instructions to follow and you will also be given a pain diary. The pain dairy is what you will use in recording your pain relieving process.

You may feel immediate pain relief or may not feel immediate pain relief. If you feel immediate pain relief, it means that the medication is at the right spot and it is having effects.

If you don’t feel immediate pain relief, it may be that the medication has not reached the right spot or has not started working.

You may as well feel pain relief and the pain will return after a few days. This may occur due to the fact that the effect of the anesthetic has worn off. The corticosteroid starts to work after two or three days and in some cases might take up to a week.

You may feel some irritation at the injection site, this can be treated by applying ice packs. It is advisable that you come to the clinic with someone who will drive you back home. You can return to work and normal activities the next day.

Results to Expect

Pain relief from this procedure differs from one patient to the other. Pain relief can be for several weeks to several months. The duration of the pain relief depends on the severity of the inflammation and injury. Some other medical and physical factors may also determine the duration of pain relief.

If there is an injury, more than one area may be injected but if the pain is caused by a minor joint issue, a single injection can lead to pain relief for a long time. The procedure may be repeated in case the pain is being felt again after some time.


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