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KMID : 0948920140130020068
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Clinical Pain
2014 Volume.13 No. 2 p.68 ~ p.75
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Diagnosis and Non-surgical, MinimalInvasive Treatment in Patients withCervical Axial Pain
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Lee Jung-Hwan
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Abstract
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Cervical axial pain is manifested as pain or discomfortaround head, neck, or interscapular area and sometimesreferred to upper extremity. Intervertebral disc and facetjoints are considered to be main source of cervical axialpain. It is difficult to make differential diagnosis betweendiscogenic and facetogenic pain because clinical manifestationand radiological evaluation are frequently not diseasespecific or not related to clinical findings. But it is importantto identify the cause of cervical axial pain because establishmentof appropriate treatment plan can lead to pain reductionand functional improvement of these patients.Diagnostic injections such as provocative discography, diagnosticmedial branch injection or intraarticular injection aresometimes required for differential diagnosis even if theseare not gold standard. The conservative managements includingmedication, physical therapy, and exercise programcan be applied in patients with cervical axial pain. But ifthese treatments failed to obtain clinical improvement,non-surgical minimal invasive treatment method can beperformed. Epidural injection and percutaneous nucleoplastyare conducted for treatment of discogenic pain, andmedial branch injection, intraarticular injection and medialbranch neurotomy are conducted for treatment of facetogenicpain. (Clinical Pain 2014;13:68-75)
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KEYWORD
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Cervical pain, Discogenic pain, Facetogenic pain, Discography, Radiofrequency
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