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Cervical zygapophysial joint pain maps.

Grant Cooper1, Beverly Bailey, Nikolai Bogduk

  • 1Department of Rehabilitation Medicine, New York-Presbyterian Hospital, The University Hospital of Columbia and Cornell, New York, NY 10021, USA. coopergr1@yahoo.com

Pain Medicine (Malden, Mass.)
|July 6, 2007
PubMed
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This study maps referred pain patterns from cervical zygapophysial joints in patients. Controlled blocks identified specific segmental pain origins, aiding diagnosis of neck pain and headache.

Area of Science:

  • Pain Medicine
  • Anatomy
  • Diagnostic Procedures

Background:

  • Cervical zygapophysial joints are a common source of neck pain and headache.
  • Understanding referred pain patterns is crucial for accurate diagnosis.

Purpose of the Study:

  • To determine and map the patterns of referred pain from cervical zygapophysial joints.
  • To differentiate pain origins based on segmental patterns.

Main Methods:

  • Analysis of pain drawings from patients with neck pain/headache undergoing diagnostic blocks.
  • Construction of composite pain maps based on positive block responses at specific segmental levels.
  • Development of probability maps indicating joint-specific pain referral areas.

Main Results:

Related Experiment Videos

  • Significant variation in referred pain patterns from individual cervical zygapophysial joints was observed.
  • Segmental pain patterns were identifiable, with overlap in adjacent segments but distinct patterns in remote segments.
  • Guidelines were derived to help practitioners distinguish pain from adjacent segments.

Conclusions:

  • Pain maps derived from controlled blocks in symptomatic patients are more accurate for identifying cervical zygapophysial joint pain origin.
  • These maps offer a better diagnostic guide than those based on studies of normal volunteers.