• L Barnsley, S M Lord, B J Wallis, and N Bogduk.
• Cervical Spine Research Unit, Faculty of Medicine, University of Newcastle, Callaghan, Australia.
• Spine. 1995 Jan 1;20(1):20-5; discussion 26.

Study DesignA survey of the prevalence of cervical zygapophysial joint pain was conducted.ObjectivesTo determine the prevalence of cervical zygapophysial joint pain in patients with chronic neck pain after whiplash.Summary Of Background DataIn a significant proportion of patients with whiplash, chronic, refractory neck pain develops. Provisional data suggest many of these patients have zygapophysial joint pain, but the diagnosis has been established by single, uncontrolled diagnostic blocks.MethodsFifty consecutive, referred patients with chronic neck pain after whiplash injury were studied using double-blind, controlled, diagnostic blocks of the cervical zygapophysial joints. On separate occasions, the joint was blocked with either lignocaine or bupivacaine in random order.ResultsA positive diagnosis was made only if both blocks relieved the patient's pain and bupivacaine provided longer relief. Painful joints were identified in 54% of the patients (95% confidence interval, 40% to 68%).ConclusionIn this population, cervical zygapophysial joint pain was the most common source of chronic neck pain after whiplash.

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