Some patients with cervical spondylosis do not achieve adequate neck pain relief after completing a full course of first-line conservative care. This protocol describes the structured next step for that situation.
First-line conservative management — multimodal physical therapy comprising education, pain-relieving techniques, neuromuscular and sensorimotor training, and self-management strategies, together with analgesia as required — did not achieve the target of relief of neck pain.
When conservative care has not achieved adequate pain relief, management may shift toward interventional approaches directed specifically at the cervical zygapophyseal (facet) joints.
The complete protocol — including the specific interventional modalities, selection criteria, and sequencing — is available via the link below.
DOI: 10.1093/rap/rkaf127
Interventions for mechanical neck pain and cervical spondylosis are less invasive and are frequently directed to the zygapophyseal joints in the form of diagnostic nerve or joint blocks, radiofrequency neurotomies (RFN) or intra-articular joint corticosteroid injections.
There is increasing interest in regenerative medicine therapies, with preliminary evidence of some benefits for intra-articular platelet-rich plasma (PRP) for facet joint pain.
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