Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, localized left-sided cervical pain, exacerbated by neck extension and rotation to the left. Pain is described as dull and aching, occasionally radiating to the left trapezius or scapular region, without objective neurological deficits or radicular symptoms. Symptoms are refractory to conservative management including NSAIDs and physical therapy.
Clinical Examination Findings
Physical examination reveals localized tenderness upon palpation of the left cervical facet joints (C3-C7). Range of motion is restricted in left lateral rotation and extension, eliciting concordant pain. Spurlingโs test is negative. Neurological examination is intact: motor strength 5/5 in bilateral upper extremities, sensation intact to light touch, and deep tendon reflexes are 2+ and symmetric.
Treatment Protocol
Recommended treatment plan includes a trial of targeted physical therapy focusing on cervical stabilization and postural correction. If symptoms persist, consider diagnostic left-sided cervical medial branch blocks (MBB) to confirm the facet joint as the primary pain generator, followed by potential radiofrequency ablation (RFA) for long-term management.