Zygapophyseal Joint Pain Patterns: Part 1B (Cervical Spine)

CERVICAL ZYGAPOPHYSEAL JOINT PAIN PATTERNS II: A clinical evaluation (Aprill et. al., Spine, 1990)

A study testing the reliability of their pain charts by a clinical trial

Guiding principle: if the pain patterns could correctly identify the source of neck pain, they could then be used as diagnostic aids in the clinical assessment of neck pain.

10 subjects used and were administered diagnostic blocks according to the above pain patterns. A positive response was recorded if within 10 minutes, the blocks provided complete relief of pain lasting for the duration of action of the local anesthetic agent used

The diagnostic blocks used were cervical medial branch blocks performed under image intensifier using a lateral approach

In eight cases, there was complete concordance in the predicted levels between the first and second observers

In nine of ten patients, there was complete concordance between the predicted level and the positive response to blocks

Most patients reported areas that were more extensive than those seen in normal volunteers. Therefore, it appears that with stronger stimuli, the pain can spread beyond the core area, overlapping into adjacent zones

Results demonstrated that the segmental pain charts could be used with good accuracy to predict the segmental location of the symptomatic joint