Effect of adding cervical facet joint injections in a multimodal treatment program for long-standing cervical myofascial pain syndrome with referral pain patterns of cervical facet joint syndrome

Cervical facet joint (CFJ) syndrome is a common disorder observed in chronic pain of the cervical region, especially in long-standing myofascial pain syndrome (MPS). This study aimed to investigate the effects of therapeutic CFJ injections on patients with long-standing cervical MPS with referral pain patterns of CFJ syndrome. Four hundred patients presented with long-standing cervical MPS with referral pain patterns of CFJ syndrome over a period of 6 months. A randomized clinical trial was performed wherein 200 patients (group 1) received therapeutic CFJ injections at bilateral C5/C6 and C6/C7 after diagnostic, controlled double-blind blocks. The same cointerventions, such as medication and a home exercise program, were simultaneously applied to patients in group 1 and the noninjection group (group N). Cervical range of motion (CROM), mean reduction of numeric rate scale (NRS) for pain, and comorbid tension-type headache were compared between groups during the 1-year follow-up period. Treatment duration and symptom-free periods were compared according to age group. Group 1 showed increased CROM, increased mean NRS pain reduction, and decreased incidence of combined tension-type headache compared with group N during the follow-up. Younger patients in group 1 required a shorter treatment cycle and experienced a longer symptom-free period. Addition of therapeutic CFJ injections to a multimodal treatment program is a useful therapeutic modality for patients, especially young patients, suffering from long-standing MPS with referral pain of CFJ syndrome.