Abstract | BACKGROUND: Chronic neck pain is a common problem in the adult population with a typical 12-month prevalence of 30% to 50%. However, there is a lack of consensus regarding the causes and treatments of chronic neck pain. Despite limited evidence, cervical epidural injections are one of the commonly performed non-surgical interventions in the management of chronic neck pain. STUDY DESIGN: A randomized, double-blind, active control trial. SETTING: An interventional pain management practice, a specialty referral center, a private practice setting in the United States. OBJECTIVES: METHODS: Patients without disc herniation or radiculitis and negative for facet joint pain by means of controlled diagnostic medial branch blocks were randomly assigned to one of 2 groups: injection of local anesthetic only or local anesthetic mixed with non-particulate betamethasone. Seventy patients were included in this analysis. Randomization was performed by computer-generated random allocation sequence by simple randomization. OUTCOMES ASSESSMENT: Multiple outcome measures were utilized including the Numeric Rating Scale (NRS), the Neck Disability Index (NDI), employment status, and opioid intake with assessment at 3, 6, and 12 months post-treatment. Significant pain relief or functional status was defined as a 50% or more reduction. RESULTS: Significant pain relief (> or = 50%) was demonstrated in 80% of patients in both groups and functional status improvement (> or = 50%) in 69% of Group I and 80% of Group II. The overall average procedures per year were 3.9 +/- 1.01 in Group I and 3.9 +/- 0.8 in Group II with an average total relief per year of 40.3 +/- 14.1 weeks in Group I and 42.1 +/- 9.9 weeks in Group II over a period of 52 weeks in the successful group. LIMITATIONS: The results of this study are limited by the lack of a placebo group and a preliminary report of 70 patients, with 35 patients in each group. CONCLUSION:
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Authors | Laxmaiah Manchikanti, Kimberly A Cash, Vidyasagar Pampati, Bradley W Wargo, Yogesh Malla |
Journal | Pain physician
(Pain Physician)
2010 Jul-Aug
Vol. 13
Issue 4
Pg. E265-78
ISSN: 2150-1149 [Electronic] United States |
PMID | 20648213
(Publication Type: Journal Article, Randomized Controlled Trial)
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Chemical References |
- Anesthetics, Local
- Steroids
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Topics |
- Adult
- Anesthetics, Local
(administration & dosage, adverse effects)
- Cervical Vertebrae
(diagnostic imaging, drug effects, physiopathology)
- Chronic Disease
- Double-Blind Method
- Female
- Humans
- Injections, Epidural
(adverse effects, methods)
- Intervertebral Disc
(diagnostic imaging, drug effects, pathology)
- Intervertebral Disc Degeneration
(drug therapy)
- Intervertebral Disc Displacement
(physiopathology)
- Male
- Middle Aged
- Neck Pain
(drug therapy, etiology, physiopathology)
- Radiography
- Steroids
(administration & dosage, adverse effects)
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