Open AccessEffectiveness of Intra‐Articular Steroid Injection for Atlanto‐Occipital Joint Pain
Author(s) -
Lee DongGyu,
Cho YunWoo,
Jang SungHo,
Son SuMin,
Kim GookJoo,
Ahn SangHo
Publication year - 2015
Publication title -
pain medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.893
H-Index - 97
eISSN - 1526-4637
pISSN - 1526-2375
DOI - 10.1111/pme.12474
Subject(s) - medicine , neck pain , anesthesia , refractory (planetary science) , visual analogue scale , local anesthetic , surgery , physics , alternative medicine , pathology , astrobiology
Objectives The aims of this study were to evaluate the role of intra‐articular joint injection for atlanto‐occipital ( AO ) joint pain and to determine pain referral sites from that joint. Design Prospective observational study. Method We evaluated 29 patients with chronic refractory neck pain and/or headache, and limited range of lateral bending with rotation at the AO joint on physical examination. Of the 24 patients who consented to undergo diagnostic injections, 20 patients had at least 50% relief from pain and underwent two AO intra‐articular injections of mixture of local anesthetic and steroid approximately 1 week apart. Patients completed pain drawings, visual analog scales ( VASs ) for pain, and neck disability index ( NDI ) for level of function. Patients were evaluated for 2 months after the first injection. Result There was headache in 14/20 (70%), posterior neck pain ( PNP ) in 20, and referred pain in 17 (85%). The average VAS values for headache, PNP , and other referred pains were reduced significantly from 5.64, 5.70, and 5.41, respectively, before treatments to 0.64, 2.30, and 1.71, respectively, two months after injection ( P < 0.01). The average NDI value was reduced significantly from 39.95% at pretreatment to 20.40% at 2 months after treatment ( P < 0.01). Conclusion AO intra‐articular steroid injection appears effective for the short‐term control of chronic refractory pain arising from the AO joint.