Utah Pain Management | Nexus Pain Care Utah Pain Clinic
6.jpg
Home Team Approach Treat Testimonials News Mission Contact
   
Go Back  
     
   
CERVICAL-MECHANICAL PAIN—CAUSES AND TREATMENTS

Cervical Facet Joint Syndrome

The diagnosis of cervical facet joint syndrome is given to patients whose pain arises from the cervical zygapophysial (facet) joints located in the back of the neck.  Multiple lines of evidence have shown that the facet joints are capable of producing pain

Cervical zygapophysial joint pain is not only common, but is the single most common cause for chronic neck pain after whiplash. The prevalence of cervical facet joint pain has been estimated to be as high as 88% in patients who are involved in high speed accidents.

In a double-blind, placebo-controlled study, it was established that 70% of patients who obtained relief from medial branch blocks could obtain complete relief of pain if treated with radiofrequency lesioning.  This study also showed unequivocally the results of cervical medial branch radiofrequency ablation were not a placebo. 

A later study showed that long-term relief, greater than 200 days, could be obtained after the procedure. 

The development of the theory and practice of cervical medial branch blocks has attracted international recognition by several prestigious organizations, including the Cervical Spine Research Society. 

(The above information was obtained from the ISIS 9th Annual Scientific Meeting Syllabus).

April et al.  Cervical Zygapophysial Joint Pain Patterns ll: a clinical evaluation. Spine 1990;15:458-461.
Gibson et al.  Crash Characteristics of Whiplash Associated Chronic Neck Pain. J Musculoskeletal Pain 2000; 8:98-95.

Bogdik N., Low Back Pain.  Clinical Anatomy of Lumbar Spine and Sacrum.  Third edition.  Churchill Livingston, New York, 1997; pp 187-213.

Dwyer et al.  Cervical Zygapophysial Joint Pain Patterns I: a study in normal volunteers. Spine 1990;15:453-457.

Lord et al.  Percutaneous Radio-Frequency Neurotomy for Chronic Cervical Zygapophysial Joint Pain. N Engl J Med 1996: 335:1721-1726.

McDonald et al.  Long-term Follow-up of Patients Treated with Cervical Radiofrequency Neurotomy for Chronic Neck Pain.  Neurosurgery1999; 45:61-68.
 
 
Cervical Facet Joint Injection

Arthritis is acute or chronic inflammation of a joint, often accompanied by pain and structural changes and having diverse causes, such as infection, crystal deposition, or injury.

Patients who suffer from Arthritis are most commonly treated by rheumatologists.
 
 
Cervical Medial Branch Block

In order to accurately diagnose the source of neck pain, a cervical medial branch block must be performed. This procedure involves anesthetizing the nerve to the appropriate facet joint with a local anesthetic.  Should the patient receive good pain relief with this procedure, one can assume that the origin of the pain is, indeed, the facet joint.

The major indications for performing this procedure include focal tenderness over a facet joint, chronic neck pain with normal radiographic evaluation, neck pain with known facet/disc disease and finally, post-laminectomy syndrome.

It has been shown by Dr Dreyfuss and others that there is no definitive test or physical examination which is specific for facet arthropathy.  MRIs and other imaging modalities might prove negative as they are static in nature.

Facet joint pain is due to micro-movements secondary to ligamentous laxity. This will not be appreciated with conventional methods. One must, therefore, anesthetize the joint and determine if the patient receives concordant pain relief. Should this occur, there is a 70% chance that long-term pain relief could be obtained with a radio frequency lesioning procedure.
 
 
Cervical Medial Branch Radio Frequency

Cervical means of or related to the neck.

After a patient has undergone the proper diagnostic tests (nerve block injections), our doctors educate our patients about radio frequency lesioning—a procedure that typically results in 12-24 months of pain relief. 

Using high-frequency radio waves and heat, our physicians pulse the pain generating nerve.  Through this process, the pain sensory on the nerve is de-activated.  The nerve is still functioning, but there is no more pain.  Most insurance companies will cover this treatment at least once a year.

“Many conditions can be treated by simply targeting the painful nerve and treating it with our radio frequency procedures.  Thanks to these medical advances, we can offer effective treatments without the risk and recovery time of surgery,’” says Dr. Richard Rosenthal, the medical director of Nexus Paincare.
 
    Back to Top
801-356-6100
3585 North University Ave. Suite 150 - Provo, UT
801-865-7428
 
3336 South Pioneer Parkway, #201 - West Valley City, UT
801-833-6569
 
3570 West 9000 South, Ste. 200 - West Jordan, UT
435-630-9297
 
377 North Fairgrounds Road - Price, UT
 
435-602-9259
© 2010 Nexus Pain Care, All Rights Reserved
35 South 500 East - Heber City, UT