Those receiving disability, worker's compensation, or are involved in litigation related 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.

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.

Cortisone Shots for Neck Pain