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

Journal of Anesthesia, 06/08/2012

Addition of therapeutic cervical facet joint (CFJ) injections to a multimodal treatment program is a useful therapeutic modality for patients, especially young patients, suffering from long–standing myofascial pain syndrome (MPS) with referral pain of CFJ syndrome.


  • 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.


  • 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.

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