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7. Cervical facet pain: Degenerative alterations and whiplash‐associated disorder.

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Title: 7. Cervical facet pain: Degenerative alterations and whiplash‐associated disorder.
Authors: Hellinga, M. D., van Eerd, M., Stojanovic, M. P., Cohen, S. P., de Andrès Ares, J., Kallewaard, J. W., Van Boxem, K., Van Zundert, J., Niesters, M.
Source: Pain Practice. Feb2025, Vol. 25 Issue 2, p1-16. 16p.
Subjects: Neck pain treatment, Treatment of whiplash injuries, Physical diagnosis, Exercise therapy, Radio frequency therapy, Analgesia, Pain management, Cervical vertebrae, Range of motion of joints
Abstract: Introduction: Pain from the cervical facet joints, either due to degenerative conditions or due to whiplash‐related trauma, is very common in the general population. Here, we provide an overview of the literature on the diagnosis and treatment of cervical facet‐related pain with special emphasis on interventional treatment techniques. Methods: A literature search on the diagnosis and treatment of cervical facet joint pain and whiplash‐associated disorders (WAD) was performed using PubMed, Cochrane, and Embase databases. All relevant literature was retrieved and summarized. Results: Facet‐related pain is typically diagnosed based on history and physical examination of the patients, combined with a diagnostic block (eg, with local anesthetic) of the medial branches innervating the joints. There is no additive value for imaging techniques to diagnose cervical facet pain, but imaging may be used for procedure planning. First‐line therapy for pain treatment includes focused exercise, graded activity, and range‐of‐motion training. Pharmacological treatment may be considered for acute facet joint pain; however, for chronic facet joint pain, evidence for pharmacological treatment is lacking. Considering the lack of evidence for treatment with botulinum toxin, intra‐articular steroid injections, or surgery, these interventions are not recommended. Diagnostic blocks are not considered a viable treatment option, though some patients may experience a prolonged analgesic effect. Long‐term analgesia (>6 months) has been observed for radiofrequency treatment of the medial branches. Conclusions: Cervical facet pain is diagnosed based on history, physical examination, and a diagnostic block of the medial branches innervating the painful joints. Conservative management, including exercise therapy, is the first line of treatment. When conservative management does not result in adequate improvement of pain, radiofrequency treatment of the medial branches should be considered, which often results in adequate pain relief. [ABSTRACT FROM AUTHOR]
Copyright of Pain Practice is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: 7. Cervical facet pain: Degenerative alterations and whiplash‐associated disorder.
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  Data: <searchLink fieldCode="JN" term="%22Pain+Practice%22">Pain Practice</searchLink>. Feb2025, Vol. 25 Issue 2, p1-16. 16p.
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  Data: <searchLink fieldCode="DE" term="%22Neck+pain+treatment%22">Neck pain treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+of+whiplash+injuries%22">Treatment of whiplash injuries</searchLink><br /><searchLink fieldCode="DE" term="%22Physical+diagnosis%22">Physical diagnosis</searchLink><br /><searchLink fieldCode="DE" term="%22Exercise+therapy%22">Exercise therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Radio+frequency+therapy%22">Radio frequency therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Analgesia%22">Analgesia</searchLink><br /><searchLink fieldCode="DE" term="%22Pain+management%22">Pain management</searchLink><br /><searchLink fieldCode="DE" term="%22Cervical+vertebrae%22">Cervical vertebrae</searchLink><br /><searchLink fieldCode="DE" term="%22Range+of+motion+of+joints%22">Range of motion of joints</searchLink>
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  Data: Introduction: Pain from the cervical facet joints, either due to degenerative conditions or due to whiplash‐related trauma, is very common in the general population. Here, we provide an overview of the literature on the diagnosis and treatment of cervical facet‐related pain with special emphasis on interventional treatment techniques. Methods: A literature search on the diagnosis and treatment of cervical facet joint pain and whiplash‐associated disorders (WAD) was performed using PubMed, Cochrane, and Embase databases. All relevant literature was retrieved and summarized. Results: Facet‐related pain is typically diagnosed based on history and physical examination of the patients, combined with a diagnostic block (eg, with local anesthetic) of the medial branches innervating the joints. There is no additive value for imaging techniques to diagnose cervical facet pain, but imaging may be used for procedure planning. First‐line therapy for pain treatment includes focused exercise, graded activity, and range‐of‐motion training. Pharmacological treatment may be considered for acute facet joint pain; however, for chronic facet joint pain, evidence for pharmacological treatment is lacking. Considering the lack of evidence for treatment with botulinum toxin, intra‐articular steroid injections, or surgery, these interventions are not recommended. Diagnostic blocks are not considered a viable treatment option, though some patients may experience a prolonged analgesic effect. Long‐term analgesia (>6 months) has been observed for radiofrequency treatment of the medial branches. Conclusions: Cervical facet pain is diagnosed based on history, physical examination, and a diagnostic block of the medial branches innervating the painful joints. Conservative management, including exercise therapy, is the first line of treatment. When conservative management does not result in adequate improvement of pain, radiofrequency treatment of the medial branches should be considered, which often results in adequate pain relief. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Pain Practice is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/papr.70005
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      – SubjectFull: Neck pain treatment
        Type: general
      – SubjectFull: Treatment of whiplash injuries
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      – SubjectFull: Physical diagnosis
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      – SubjectFull: Exercise therapy
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      – SubjectFull: Radio frequency therapy
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      – SubjectFull: Cervical vertebrae
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      – SubjectFull: Range of motion of joints
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              Text: Feb2025
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