ASRA Pain Medicine Update

Consensus Practice Guidelines on Interventions for Cervical Spine (Facet) Joint Pain from a Multispecialty International Working Group

Dec 8, 2021, 17:15 PM by ASRA Pain Medicine

There are few subjects in interventional pain and spine medicine as controversial as the diagnosis, etiology, and treatment of neck pain. The past two decades have witnessed a surge in the use of cervical spine joint procedures including joint injections, nerve blocks, and radiofrequency ablation to treat chronic neck pain, yet many aspects of the procedures remain controversial. In August 2020, the American Society of Regional Anesthesia and Pain Medicine and the American Academy of Pain Medicine approved and charged the Cervical Joint Working Group to develop neck pain guidelines.

Conclusions included that cervical medial branch radiofrequency ablation may provide benefit to well-selected individuals, with medial branch blocks being more predictive than intra-articular injections. More stringent selection criteria are likely to improve denervation outcomes, but at the expense of false-negatives (ie, lower overall success rate). Clinical trials should be tailored based on objectives, and selection criteria for some may be more stringent than what is ideal in clinical practice.

Read the full guidelines here.

These guidelines were published December 8, 2021, and will be reviewed again in 2026.

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