Cervical facet joint dysfunction: a review.
OBJECTIVE
To review the relevant literature on cervical facet joint dysfunction and determine findings regarding its anatomy, etiology, prevalence, clinical features, diagnosis, and treatment.


METHODS
A computer-aided search of several databases was performed, including Medline (1966 to present), Ovid (1966 to present), and the Cochrane database (1993 to present).


METHODS
Selected articles had the following criteria: (1) all articles analyzed cervical facet joint pain-anatomy, prevalence, etiology, diagnosis, treatment; (2) only full, published articles were studied, not abstracts; and (3) all articles were published in English.


METHODS
All articles were critically evaluated and included the following categories: randomized controlled trials, meta-analyses, uncontrolled clinical trials, uncontrolled comparison studies, nonquantitative systematic reviews, and literature-based reviews.


RESULTS
We examined 45 references that consisted of 44 journal articles and relevant sections from 1 textbook. Cervical facet joints have been well established in the literature as a common nociceptive pain generator, with an estimated prevalence that ranges from 25% to 66% of chronic axial neck pain. No studies have reported clinical examination findings that are diagnostic for cervical facet mediated pain.


CONCLUSIONS
Overall the literature provides very limited information regarding the treatment of this condition, with only radiofrequency neurotomy showing evidence of effectively reducing pain from cervical facet joint dysfunction.
Kirpalani
Dhiruj
D
Division of Physical Medicine and Rehabilitation, Stanford University Medical Center, Palo Alto, CA 94305, USA. rmitra@stanford.edu
Mitra
Raj
R
D000700:Analgesics / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D018771:Arthralgia / Q000175:diagnosis / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D015201:Meta-Analysis as Topic; D019547:Neck Pain / Q000175:diagnosis / Q000534:rehabilitation*; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function; D018570:Risk Assessment; D012720:Severity of Illness Index; D004561:Transcutaneous Electric Nerve Stimulation; D016896:Treatment Outcome; D021801:Zygapophyseal Joint / Q000503:physiopathology*
D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal