Effect of adding cervical facet joint injections in a multimodal treatment program for long-standing cervical myofascial pain syndrome with referral pain patterns of cervical facet joint syndrome.
OBJECTIVE
Cervical facet joint (CFJ) syndrome is a common disorder observed in chronic pain of the cervical region, especially in long-standing myofascial pain syndrome (MPS). This study aimed to investigate the effects of therapeutic CFJ injections on patients with long-standing cervical MPS with referral pain patterns of CFJ syndrome.


METHODS
Four hundred patients presented with long-standing cervical MPS with referral pain patterns of CFJ syndrome over a period of 6 months. A randomized clinical trial was performed wherein 200 patients (group 1) received therapeutic CFJ injections at bilateral C5/C6 and C6/C7 after diagnostic, controlled double-blind blocks. The same cointerventions, such as medication and a home exercise program, were simultaneously applied to patients in group 1 and the noninjection group (group N). Cervical range of motion (CROM), mean reduction of numeric rate scale (NRS) for pain, and comorbid tension-type headache were compared between groups during the 1-year follow-up period. Treatment duration and symptom-free periods were compared according to age group.


RESULTS
Group 1 showed increased CROM, increased mean NRS pain reduction, and decreased incidence of combined tension-type headache compared with group N during the follow-up. Younger patients in group 1 required a shorter treatment cycle and experienced a longer symptom-free period.


CONCLUSIONS
Addition of therapeutic CFJ injections to a multimodal treatment program is a useful therapeutic modality for patients, especially young patients, suffering from long-standing MPS with referral pain of CFJ syndrome.
Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Bumeuri, Mulgeumup, Yangsan, Kyungsangnamdo, 626-770, Korea.
Sung-Chun
SC
Park
Kyung-Hoon
KH
Kim
D000082:Acetaminophen / Q000008:administration & dosage; D018681:Anesthetics, General / Q000008:administration & dosage*; D059350:Chronic Pain / Q000188:drug therapy*; D003000:Clonidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D003061:Codeine / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage; D007267:Injections / Q000379:methods; D008297:Male; D008875:Middle Aged; D009209:Myofascial Pain Syndromes / Q000188:drug therapy / Q000628:therapy*; D019547:Neck Pain / Q000188:drug therapy / Q000628:therapy*; D010147:Pain Measurement / Q000379:methods; D011446:Prospective Studies; D021801:Zygapophyseal Joint / Q000187:drug effects*
D018681:Anesthetics, General; D000082:Acetaminophen; C023754:tizanidine; D003000:Clonidine; D003061:Codeine; D007052:Ibuprofen