Definition and discussion
Cervical facet joint irritation or damage that may cause cranial, cervical or upper shoulder and or arm pain referral; often difficult to differentiate from other causes of neck pain.
Aetiology
Neck pain in the general population is approximately 34% at any given time. Chronic neck pain (defined here as pain lasting 6 months or longer) is approximately 14%. It is estimated that 26-65% of neck pain complaints have a cervical facet component.
History, signs and symptoms
Causes of cervical facet syndrome:
- Injury of the muscles, ligaments and joint capsule of the cervical spine
- Cervical disc injuries are associated with facet joint pain in about 40% of cases
- Whiplash, sprain/strain injuries
- Osteoarthrosis or RA
- Repetitive stress, poor posture (occupational)
- Pain is often quite localized
- Described as a dull aching pain (may be sharp on movement)
- Headaches
- Pain may radiate to the upper shoulder and/or upper back regions
- During physical examination pain may be increased on extension, lateral flexion and rotation (due to facet joint approximation)
- Antalgia is typically away from the facet joint
- Possible muscle splinting and guarded ROM
Treatment
- Soft tissue massage, ischemic compression, manipulation and myofascial dry needling
- Also rest, ice, heat etc
- Passive (stretching) and active range of motion exercises to be performed in a pain free
- Home care: ice and heat application as well as sleeping, sitting and standing postural
- Medications such as NSAIDs and analgesics for pain control and muscle
