To determine the prevalence of disc pain and zygapophysial joint pain
occurring simultaneously in the same segment of the neck, 56 patients
with post-traumatic neck pain underwent both provocation discography a
nd cervical zygapophysial joint blocks. Both a symptomatic disc and a
symptomatic zygapophysial joint were identified in the same segment in
41% of the patients. Discs alone were symptomatic in only 20% of the
sample. Zygapophysial joints were symptomatic but discs asymptomatic i
n 23%. Only 17% of the patients had neither a symptomatic disc nor a s
ymptomatic zygapophysial joint at the segments studied. These observat
ions indicate that the investigation of neck pain by discography alone
or by zygapophysial blocks alone constitutes an inadequate approach t
o neck pain which fails to identify the majority of patients whose sym
ptoms stem from multiple elements in the 3-joint complexes of the neck
.