Chronic Neck Pain (chronic + neck_pain)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

The Prevalence of Facet Joint-Related Chronic Neck Pain in Postsurgical and Nonpostsurgical Patients: A Comparative Evaluation

PAIN PRACTICE, Issue 1 2008
Laxmaiah Manchikanti MD
,,Abstract Background: Facet (zygapophysial) joints may be clinically important sources of chronic cervical spinal pain. Previous studies have demonstrated the value and validity of controlled, comparative local anesthetic blocks in the diagnosis of facet joint pain, and reported an overall prevalence of 36% to 67% facet joint involvement in cervical spinal pain. The reports of lumbar facet joint-involvement in postsurgery syndrome have been shown to be highly variable with prevalence ranging from 8% to 32%. To date, however, the prevalence of postsurgical facet joint-related pain in the cervical spine has not been evaluated. In light of this, the present retrospective study was conducted to assess and compare the prevalence of chronic postsurgical facet joint cervical spinal pain to nonsurgical, chronic cervical facet joint pain. Methods: Patients presenting with chronic neck pain were studied. The procedures were performed by a single physician in an interventional pain management ambulatory surgery center. The prevalence of cervical facet joint pain in postsurgical patients was assessed and compared to nonsurgical patients. Results: A total of 251 patients (45 postsurgery vs. 206 nonsurgical patients) with chronic persistent neck pain were evaluated using controlled, comparative local anesthetic blocks in accordance with IASP criteria. The prevalence of the cervical facet joint pain and false-positive rate of single blocks in postsurgical patients were 36% and 50% compared with 39% and 43% in nonsurgical patients. Conclusions: Cervical facet joints are clinically important pain generators in a significant proportion of patients with chronic persistent neck pain after surgical intervention(s). The prevalence of cervical facet joint pain was similar in both postsurgical and nonsurgical patients.,, [source]

Acute Intracranial Hemorrhage in the Brain Caused by Acupuncture

HEADACHE, Issue 5 2000
Daniel Chung Ann Choo MD
A 44-year-old Chinese man developed severe occipital headache, nausea, and vomiting during acupuncture treatment of the posterior neck for chronic neck pain. Computed tomography of the head showed hemorrhage in the fourth, third, and lateral ventricles. A lumbar puncture confirmed the presence of blood. Magnetic resonance angiography with gadolinium did not reveal any saccular aneurysms or arteriovenous malformations. The patient's headache resolved over a period of 28 days without any neurological deficits. Acupuncture of the posterior neck can cause acute intracranial hemorrhage. [source]

Botulinum Neurotoxin-A for Treatment of Refractory Neck Pain: A Randomized, Double-Blind Study

PAIN MEDICINE, Issue 6 2009
Diana Miller MD
ABSTRACT Objective., To investigate the efficacy and tolerability of Botulinum neurotoxin-A (BoNT-A) in the patients with refractory neck pain. Background., An analgesic effect is suggested for BoNT-A by a number of animal studies. Two blinded studies suggested efficacy of BoNT-A in a chronic neck pain. Methods., Forty-seven subjects were enrolled in a prospective, double-blind, placebo-controlled study. A total of 150 to 300 units of BoNT-A were injected into the neck and shoulder muscles based on pain localization. Subjects completed the visual analog scale (VAS), Pain Frequency Questionnaire and the Modified Oswestry Pain Questionnaire (MOPQ) at baseline, 3 and 8 weeks after the treatment. The primary outcomes consisted of: 1) ,50% improvement on the VAS; and 2) ,30% reduction in pain day frequency. The secondary outcome was an improvement of ADL in MOPQ. Excellent responders (ERs) were those who met all three outcomes. Results., At 2 months, a significant reduction in the mean VAS (pain intensity) was noted in the BoNT-A group compared with the placebo (P = 0.0018, CI 95% from 2.51 to 7.89). At 2 months, there were six ERs in the BoNT-A group and one ER in the placebo group (P = 0.0152). Conclusion., Administration of BoNT-A into the neck and shoulder muscles for treatment of chronic refractory neck pain met one of the two primary outcomes: reduction in pain intensity. More ERs were noted in the Botox group. [source]

The Prevalence of Facet Joint-Related Chronic Neck Pain in Postsurgical and Nonpostsurgical Patients: A Comparative Evaluation

PAIN PRACTICE, Issue 1 2008
Laxmaiah Manchikanti MD
,,Abstract Background: Facet (zygapophysial) joints may be clinically important sources of chronic cervical spinal pain. Previous studies have demonstrated the value and validity of controlled, comparative local anesthetic blocks in the diagnosis of facet joint pain, and reported an overall prevalence of 36% to 67% facet joint involvement in cervical spinal pain. The reports of lumbar facet joint-involvement in postsurgery syndrome have been shown to be highly variable with prevalence ranging from 8% to 32%. To date, however, the prevalence of postsurgical facet joint-related pain in the cervical spine has not been evaluated. In light of this, the present retrospective study was conducted to assess and compare the prevalence of chronic postsurgical facet joint cervical spinal pain to nonsurgical, chronic cervical facet joint pain. Methods: Patients presenting with chronic neck pain were studied. The procedures were performed by a single physician in an interventional pain management ambulatory surgery center. The prevalence of cervical facet joint pain in postsurgical patients was assessed and compared to nonsurgical patients. Results: A total of 251 patients (45 postsurgery vs. 206 nonsurgical patients) with chronic persistent neck pain were evaluated using controlled, comparative local anesthetic blocks in accordance with IASP criteria. The prevalence of the cervical facet joint pain and false-positive rate of single blocks in postsurgical patients were 36% and 50% compared with 39% and 43% in nonsurgical patients. Conclusions: Cervical facet joints are clinically important pain generators in a significant proportion of patients with chronic persistent neck pain after surgical intervention(s). The prevalence of cervical facet joint pain was similar in both postsurgical and nonsurgical patients.,, [source]

Are cervical physical outcome measures influenced by the presence of symptomatology?

PHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 3 2002
Michele Sterling
Abstract Background and Purpose Outcome measures must be repeatable over time to judge changes as a result of treatment. It is unknown whether the presence of neck pain can affect measurement reliability over a time period when some change could be expected as a result of an intervention. The present study investigated the reliability of two measures, active cervical range of movement (AROM) and pressure pain thresholds (PPTs), in symptomatic and asymptomatic subjects. Method A repeated-measures study design with one week between testing sessions was used. Nineteen healthy asymptomatic subjects and 19 subjects with chronic neck pain participated in the study. The neck movements measured were: flexion, extension, right and left lateral flexion, and axial rotation. PPTs were measured over six bilateral sites, both local and remote to the cervical spine. Results The between-week intra-class correlation coefficients (ICCs2,1) for AROM ranged from 0.67 to 0.93 (asymptomatic group) and from 0.64 to 0.88 (chronic neck pain group). Standard error of measurement (SEM) was similar in both groups, from 2.66° to 5.59° (asymptomatic group) and from 2.36° to 6.72° (chronic neck pain group). ICCs2,1 for PPTs ranged from 0.70 to 0.91 (asymptomatic group) and from 0.69 to 0.92 (chronic neck pain group). SEM ranged from 11.14 to 87.71 kPa (asymptomatic group) and from 14.25 to 102.95 kPa (chronic neck pain group). Conclusions The findings of moderate to very high between-week reliability of measures of AROM and PPTs in both asymptomatic and chronic neck pain subjects suggest the presence of symptomatology does not adversely affect reliability of these measures. The results support the use of these measures for monitoring change in chronic neck pain conditions. Copyright © 2002 Whurr Publishers Ltd. [source]