Therapeutic zygapophyseal joint injections for headaches emanating from the C2-3 joint.

Abstract

OBJECTIVE:

To report our experience using fluoroscopically guided therapeutic intra-articular C2-3 zygapophyseal joint injections in patients with chronic headaches after a whiplash event.

DESIGN:

Restrospective study (n = 18 patients) with independent clinical review. Each patient experienced persistent daily headache symptoms which failed to improve after at least 3 mo of physical therapy, activity restriction, and the use of oral analgesics. Each patient demonstrated initially a positive response to a diagnostic intra-articular C2-3 joint injection. Data collection and analysis were performed by an independent clinical reviewer. Outcome measures included headache frequency, medication usage, symptom response to medication, and employment status.

RESULTS:

Patients' symptom duration before diagnostic injection averaged 34 mo. Follow-up data collection transpired at an average of 19 mo after the final therapeutic injection. In 61% of patients, fewer than three headaches were experienced each week; these headaches were relieved with the use of oral analgesics.

CONCLUSIONS:

Although the inherent limitations of this study preclude a definitive statement regarding the efficacy of C2-3 injections, these initial findings suggest that therapeutic intra-articular zygapophyseal joint injections are effective in the treatment of headaches emanating from the C2-3 joint after a whiplash event. Future controlled, prospective studies are necessary to clarify the role of such injections in this challenging patient population.

• Authors: C W Slipman, J S Lipetz, C T Plastaras, H B Jackson, S T Yang, A M Meyer
• Journal: American journal of physical medicine & rehabilitation (Am J Phys Med Rehabil) Vol. 80 Issue 3 Pg. 182-8 (Mar 2001) ISSN: 0894-9115 [Print] United States
• PMID: 11237272 (Publication Type: Journal Article)

Chemical References

• Anesthetics, Local
• Anti-Inflammatory Agents
• Drug Combinations
• Betamethasone
• Lidocaine

Topics

• Adult
• Anesthetics, Local (therapeutic use)
• Anti-Inflammatory Agents (therapeutic use)
• Betamethasone (therapeutic use)
• Cervical Vertebrae
• Chronic Disease
• Drug Combinations
• Female
• Fluoroscopy (instrumentation, methods)
• Headache (classification, drug therapy, etiology)
• Humans
• Injections, Intra-Articular (instrumentation, methods)
• Lidocaine (therapeutic use)
• Male
• Middle Aged
• Radiography, Interventional (instrumentation, methods)
• Retrospective Studies
• Severity of Illness Index
• Surveys and Questionnaires
• Treatment Outcome
• Whiplash Injuries (complications)
• Zygapophyseal Joint