Derivation of a clinical prediction guide in the diagnosis of facet joint mediated pain in the cervical spine.

Funding Details
Canadian Institutes of Health Research
  • Grant type: Doctoral Award - Frederick Banting and Charles Best Canada Graduate Scholarships (CGS-D)
  • Years: 2010/11 to 2012/13
  • Total Funding: $105,000
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Project Summary

Neck pain can be a disabling condition and its physical, psychological, societal, and occupational implications can be overwhelming. The disc, facet joint, ligaments, and nerves can all be a source of pain in those with chronic neck problems. Research has shown that the facet joints can be a source of pain in up to 60% in those with chronic neck pain. The best way (gold standard) to diagnose the facet joints as the main source of pain in people with neck pain is to inject a local anaesthetic onto the nerve that signals pain from the facet joint. If the person's pain is dramatically reduced (usually 4-6 hours) than the test tells us that the facet joint may be the person's source of pain. Guidelines tell us that we need to perform this test twice, usually one to two weeks apart in order to rule out the possibility of a false positive test on the first occasion. As this specific test for facet joint pain is invasive, costly to the healthcare system, and usually involves a lengthy wait list, a clinical examination performed by health care providers that can accurately identify the facet joint as the source of someone's neck pain is optimal. Patient's participating in this study will be representative of the general population with chronic neck pain. All patients will undergo the gold standard test to diagnose facet joint pain. In this study, clinician's will gather information from the patient's history, demographics, self-report questionnaires, and clinical findings. This information will be evaluated statistically and the factors that predicted the same result, as the gold standard test will form the clinical prediction guide that clinician's can use when examining patients with chronic neck pain. This clinical prediction guide may be useful in reducing wait list time for the gold standard facet joint test, decreasing the need to put patient's through an invasive procedure, and reduce health care costs associated with the gold standard test.