Treatment of Neck Pain — Cervical Facet Joint Pain

Clinical Presentation

Patients with neck pain on one or both sides with clinical symptoms suggestive of facet joint as pain generator are very common. Many times it is being referred to as spondylosis of the cervical spine.

One such patient reported to our clinic — neck pain on right side, minimal radiation to the upper limb, had severe tenderness on the right side of neck just on the side of midline, painful neck movement, and had occasional headache. X-ray was showing straightening of cervical spine and muscle spasm, with mild reduction of C5-6 disc space.

Diagnosis with Medial Branch Block

These patients do respond well to the medial nerve branch block (blocking the nerve supplying facet joint). It is a simple injection performed under X-ray guidance. 0.5 ml of local anesthetic injection is injected under live X-ray to confirm if this nerve block gives you pain relief.

Radiofrequency Ablation Treatment

If the medial branch block helps and you are totally convinced that it relieved the pain of your neck, you can undergo a therapeutic procedure called radiofrequency (RF) ablation. RF current is delivered through a special needle under local anesthesia. To confirm if the needle is placed near the affected nerve, sensory and motor stimulation is performed using the stimulation mode on the RF generator machine. If you get good sensory and muscle stimulation in the area of your pain, it confirms the needle tip is placed in right place. Then RF energy is delivered, thermal coagulation of the nerve happens over 90 seconds at 70-80°C. To block pain of one joint, 2 nerves are to be blocked.

This procedure can relieve pain for 6 months to 2 years.

Pain recurrence is usually due to nerve regeneration. It is required to repeat the procedure after pain returns when nerve regenerates.

Do you also have neck pain with such symptoms? Don't wait and suffer — consult a pain specialist in your area and get a medial branch block done to see if it relieves your pain.