I saw a 43 year old male taxi driver in the Pain Clinic who had neck pain, particularly after prolonged periods of driving. He had taken a number of different medications, including Paracetamol, anti-inflammatories and occasional Codeine. Unfortunately, he had found these to be of little help.
On examination he had a reduction in flexion, a marked reduction in extension of the neck and reduced lateral movements of the neck. He also had difficulty in rotating his head. On palpation of the C1/2 and C7/8 cervical facet joints, this was found to reproduce his pain.
After a long discussion, he decided to go for cervical facet joint injections. This was done under aseptic technique with gloves, gown and Chlorhexidine. Local anaesthetic was administered to the skin and a thin needle was then introduced under x ray guidance down to the cervical facet joints producing the pain. There was a total of 10 mls of 0.5% Bupivacaine and 80 mg of Depo-Medrone was instilled.
He was reviewed in the Pain Clinic 4 months later. He had found the block to be particularly helpful and he was now able to carry on with his job as a driver. He had also taken on board the advice to take regular rests and do some very gentle exercises for his neck to prevent any further problems. He was then discharged from the clinic.
