Radiofrequency Neurotomy for Chronic Facet Joint Related Neck Pain
Neck PainThe researchers are planning a two-center double blind, sham-controlled randomized trial (N: 44) to assess the long term efficacy of RF neurotomy of cervical medial branches. Patients with chronic unilateral neck pain who are found eligible and achieve ≥80% pain relief of two predictive and comparative test blocks, will be included in the primary analysis. Those patients with ≥50% and < 80% pain relief will be included in a secondary analysis to examine whether a strict selection better predicts the effect of RF neurotomy. After 6 months sham-treated patients may also be offered active RF treatment. Demographic and clinical data will be recorded at baseline while primary and secondary outcome measurements are recollected after 1, 3, 6, 9 and 12 months. Primary outcome measurements include self reported neck function (NDI) and pain relief after 6 months.
Stabilization Exercises With and Without Connective Tissue Massage for Chronic Mechanical Neck Pain...
Neck Pain MusculoskeletalThe aim of this study was to investigate and compared the effects of cervical and scapulothoracic stabilization exercises with and without connective tissue massage (CTM) for patients with chronic mechanical neck pain.
RFD Versus Cervical Medial Branch Blocks in Chronic Degenerative Neck Pain
Facet Joint ArthritisPain1 moreRationale: the facet joints are an important pain generator in chronic neck pain. The beneficial effect of radio frequency treatment (RFD) of the cervical facet joints has been described in a Randomized Clinical Trial (RCT) in patients with Whiplash Associated Disorders. In patients with degenerative neck complaints a positive effect has been described in observational studies. Given this positive effect performing a RCT of RFD in this patient population is indicated. Objective: to evaluate the effect of Radio Frequency treatment in patients with chronic degenerative neck pain. Study design: prospective, randomized, double blinded clinical trial. Study population: patients older than 25 years, referred to the University Pain Center of Maastricht and the Pain Center of Amphia hospital Breda, with chronic axial neck pain. Intervention: patients with at least 3 months of neck pain without radiation to the arm (only radiation beyond the shoulder) will be randomized in 2 groups. The first group (RFD + local anesthesia-group=intervention group) will receive RF treatment adjacent to the medial branch innervating the cervical facet joints after the application of bupivacaine 0.5 ml (0.25%). The second group (local anesthesia-group=control group) will only receive the application of 0.5 ml bupivacaine (0.25%) adjacent to the medial branch. The only difference between the two groups is the RF-denervation of the medial branches. Main study parameters/endpoints: the primary research question is to evaluate the extent of pain reduction induced by RF treatment (RFD + local anesthesia-group=intervention group) compared with the local anesthesia-group(control group. Following evaluation tools are used : Numeric Rating Scale (NRS), Patient global Impression of Change on a 7 point Likert Scale (PGIC), consumption of pain medication (MQS), Patient Specific Functional Scale, Quality of life scale (RAND 36), Hospital Anxiety and Depression scale (HADS), and Neck Disability Index (NDI, Dutch version). Nature and extent of the burden and risks associated with participation, benefit and group relatedness: Patients in the RFD + Local Anesthesia-group and Local Anesthesia-group will undergo a physical examination before and 6 weeks after the intervention, by an independent third party, this will be repeated at 3 and 6 months if abnormalities are observed. At each of these time points the patients will receive questionnaires to fill out. A puncture of a blood vessel is possible, diagnosed by injection of contrast, for which repositioning of the needle is needed. Should accidental intravascular injection of local anesthetic occur, the dose used is low and reports show that intravascular injection of bupivacaine 2,5 mg does not pose clinical problems. The dura can be punctured; as a consequence contrast will flow in the cerebrospinal fluid. The procedure will be stopped and repeated after a few days. In theory a lesion of the nerve root is possible, but the needles are designed to avoid this, this complication has not been seen since more than 10 years. Up till now, a transient pain is occasionally described after the RF treatment. No hypesthesia or motor complications were reported. Since the risks of RF treatment are reported low and more related to needle placement there is no difference in risk and burden between the two treatment groups.
Electroacupuncture for Chronic Neck Pain
Neck PainObjective: The primary objective of this study is to evaluate the long-term efficacy of electroacupuncture for chronic neck pain. The secondary objective is to document any possible side effects of acupuncture. Design and Subjects: Prospective, randomised controlled trial comparing the outcomes of treatment and placebo interventions. Subjects are 200 adult patients with chronic mechanical neck pain. Setting: Outpatient clinics. Interventions: Patients will be randomly allocated to one of the two groups receiving either: electroacupuncture (real treatment) or placebo (sham laser acupuncture). Each treatment will last for 45 minutes. Each patient will receive a total of nine treatments (three times per week for three weeks). Main outcome measures: Primary outcome measures: Neck pain disability index (Northwick Park Neck Pain Questionnaire). Secondary outcome measures: Maximum pain related to motion on visual analogue scale. Quality of life (SF-36). Use of medication. Sick leave because of neck pain. Treatment-related adverse effects, such as pain, skin irritation, bleeding and dizziness, will also be assessed. Assessments will be made before treatment, one month, three months and six months after the treatment course. The credibility of placebo treatment will also be assessed. Expected results: We expect that patients in the treatment group will have significant improvements on primary and secondary outcome measures, when compared with patients in the inert placebo group. Conclusion: This study will provide credible evidence regarding whether electroacupuncture is effective in reducing chronic neck pain. Patients, healthcare professionals, and government policy makers can make use of this information to improve clinical outcomes and reduce costs
Comparing the Effect of Deep Neck Flexors Versus MCkenice Exercises on Cervical Functions
Chronic Neck PainPhysical Therapy rehabilitation programs could involve Manual procedures, stretching, traction, massage, electrotherapy, thermal agents, ultrasound, education and general exercise..In the recovery of patients with neck pain, exercise is one of the most commonly used modalities to gain muscle strength, endurance, and flexibility in order to recover damaged muscles and to maintain regular life activities.. Neck pain management exercise programs vary in terms of length, training frequency, intensity, and mode of exercise. .
Evaluation of Text Neck Syndrome and Hand Grip Force in Smart Phone Addiction Among Students of...
PainBack3 moreThis study will be conducted in the Department of physical therapy, College of Applied Medical Sciences,Jazan University, to investigate text neck syndrome and hand grip force in smart phone addiction among students of jazan university
Thrust Manipulation vs. Non-thrust Mobilizations for Mechanical Neck Pain
Neck PainThe purpose of this clinical trial is to compare the use of thrust manipulation to non-thrust mobilizations for mechanical neck pain when they are applied to both the cervical and thoracic spine. Both of these techniques have been compared in previous trials but a pragmatic approach will be employed as well as controlling for clinical equipoise.
Development of a Clinical Prediction Rulefor Neck Manipulation
Mechanical Neck PainCervical spine manipulation has been shown to be helpful for some patients with neck pain. This study sought to determine factors which were predictive of which patients with neck pain would benefit from manipulation.
Electroacupuncture and Laser Therapy on Neck Pain
Chronic Neck PainThe purpose of the study examines the use of electroacupuncture and laser therapy to treat chronic neck pain.
Comparison Between C3-6 Laminoplasty and C3 Laminectomy With Cervical Laminoplasty
Myelopathy CervicalKyphosis Post Surgical3 moreInvestigators performed a prospective randomized controlled trial for comparing postoperative clinical and radiological outcomes between C3 laminectomy with laminoplasty and C3-6 laminoplasty.