Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, localized cervical spine pain, exacerbated by neck extension and rotation. Pain is described as dull, aching, and non-radicular, often radiating to the trapezius or suprascapular region. No neurological deficits, numbness, or weakness reported. Symptoms are aggravated by prolonged static posture and relieved by rest or heat application.
Clinical Examination Findings
Cervical spine examination reveals localized paraspinal tenderness at the affected facet levels. Range of motion is restricted primarily in extension and ipsilateral rotation, reproducing the patient's concordant pain. Spurlingโs test is negative. Neurological exam is intact with normal deep tendon reflexes, motor strength (5/5), and sensory function in all dermatomes. No signs of myelopathy or radiculopathy.
Treatment Protocol
Conservative management initiated including physical therapy for postural correction and cervical stabilization exercises. Prescribed NSAIDs for inflammation and muscle relaxants as needed. Referral for diagnostic medial branch block (MBB) to confirm facet joint etiology. If diagnostic block is positive, consider radiofrequency ablation (RFA) for long-term pain management.