Classification and Treatment of Chronic Neck Pain

Abstract

Although pure neuropathic pain comprised a small percentage of our cohort, 50% of our population consisted of mixed pain conditions containing a possible neuropathic component. There was significant overlap between the various classification schemes.

Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Chronic Pain From the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, and the American Society of Anesthesiologists

“…In an era characterized by an increased emphasis on precision medicine and efforts to contain spiraling health care costs, refining selection criteria can reduce risks and costs and improve treatment outcomes. Because back pain, neck pain, and other musculoskeletal disorders, along with depression, comprise the 4 leading causes of disability in the United States, 15 determining the effectiveness of ketamine in these predominantly nonneuropathic and mixed conditions 263 , 264 is of paramount importance. Although there is stronger evidence in preclinical and clinical studies evaluating ketamine for neuropathic pain and CRPS, there is a growing body of evidence in animals for inflammatory pain and for humans in nonneuropathic spine pain.…”

Cervical flexor muscle training reduces pain, anxiety, and depression levels in patients with chronic neck pain by a clinically important amount: A prospective cohort study

“…The mean annual prevalence of neck pain is estimated at 37%, with the lifetime prevalence rate at 50% (Fejer et al, ). The causes of neck pain are multidimensional, and it is often very hard to locate the root of the problem because neck pain is a symptom and not a diagnosis (Liu et al, ). Chronic non‐specific neck pain is related to a series of impairments and disabilities: a range of reported pain, balance problems, and cognitive and emotional dysfunction (Griggs, Cook, Gargan, Bannister, & Amirfeyz, ; Robinson, Burwinkle, & Turk, ; Treleaven, ).…”

Advances in the diagnosis and management of neck pain

“…13 The only study performed in the cervical region found that 43% of 100 patients had non-neuropathic pain, 7% had predominantly neuropathic pain, and 50% had mixed pain. 14 The low proportion of patients with solely neuropathic pain probably resulted from the methodology used because selection criteria required patients to have neck pain (those with arm pain without neck pain were excluded). The high proportion of patients with mixed neuropathic-nociceptive pain was attributed to the fact that radicular pain is usually caused by degenerative conditions that predispose a person to nociceptive pain (for example, herniation occurring in a degenerative disc or facet hypertrophy resulting in foraminal stenosis).…”