THE PREVALENCE OF CHRONIC CERVICAL ZYGAPOPHYSIAL JOINT PAIN AFTER WHIPLASH

Study Design. A survey of the prevalence of cervical zygapophysial joi nt pain was conducted. Objectives. To determine the prevalence of cerv ical zygapophysial joint pain in patients with chronic neck pain after whiplash. Summary of Background Data. In a significant proportion of patients with whiplash, chronic, refractory neck pain develops. Provis ional data suggest many of these patients have zygapophysial joint pai n, but the diagnosis has been established by single, uncontrolled diag nostic blocks. Methods. Fifty consecutive, referred patients with chro nic neck pain after whiplash injury were studied using double-blind, c ontrolled, diagnostic blocks of the cervical zygapophysial joints. On separate occasions, the joint was blocked with either lignocaine or bu pivacaine in random order. Results. A positive diagnosis was made only if both blocks relieved the patient's pain and bupivacaine provided l onger relief. Painful joints were identified in 54% of the patients (9 5% confidence interval, 40% to 68%). Conclusion. In this population, c ervical zygapophysial joint pain was the most common source of chronic neck pain after whiplash.