Cervical facet joint dysfunction: a review

Arch Phys Med Rehabil. 2008 Apr;89(4):770-4. doi: 10.1016/j.apmr.2007.11.028.

Abstract

Objective: To review the relevant literature on cervical facet joint dysfunction and determine findings regarding its anatomy, etiology, prevalence, clinical features, diagnosis, and treatment.

Data sources: A computer-aided search of several databases was performed, including Medline (1966 to present), Ovid (1966 to present), and the Cochrane database (1993 to present).

Study selection: Selected articles had the following criteria: (1) all articles analyzed cervical facet joint pain-anatomy, prevalence, etiology, diagnosis, treatment; (2) only full, published articles were studied, not abstracts; and (3) all articles were published in English.

Data extraction: All articles were critically evaluated and included the following categories: randomized controlled trials, meta-analyses, uncontrolled clinical trials, uncontrolled comparison studies, nonquantitative systematic reviews, and literature-based reviews.

Data synthesis: We examined 45 references that consisted of 44 journal articles and relevant sections from 1 textbook. Cervical facet joints have been well established in the literature as a common nociceptive pain generator, with an estimated prevalence that ranges from 25% to 66% of chronic axial neck pain. No studies have reported clinical examination findings that are diagnostic for cervical facet mediated pain.

Conclusions: Overall the literature provides very limited information regarding the treatment of this condition, with only radiofrequency neurotomy showing evidence of effectively reducing pain from cervical facet joint dysfunction.

Publication types

  • Review

MeSH terms

  • Analgesics / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Arthralgia / diagnosis
  • Arthralgia / rehabilitation*
  • Female
  • Humans
  • Injections, Intra-Articular
  • Male
  • Meta-Analysis as Topic
  • Neck Pain / diagnosis
  • Neck Pain / rehabilitation*
  • Pain Measurement
  • Physical Therapy Modalities
  • Prognosis
  • Randomized Controlled Trials as Topic
  • Range of Motion, Articular / physiology
  • Recovery of Function
  • Risk Assessment
  • Severity of Illness Index
  • Transcutaneous Electric Nerve Stimulation
  • Treatment Outcome
  • Zygapophyseal Joint / physiopathology*

Substances

  • Analgesics
  • Anti-Inflammatory Agents, Non-Steroidal