In this study we will prospectively examine the safety and clinical effects of ultrasound-guided cervical medial branch blocks.

While several clinical trials have found that ultrasound guidance provides similar accuracy to fluoroscopy and reduces performance times for cervical medial branch blocks, larger studies documenting safety-related outcomes are lacking. In addition, although cervical medial branch blocks are an accepted tool to diagnose neck pain originating from the cervical facets, there are reports of long-lasting analgesic effects in a subset of patients, suggesting that these blocks may have long-term benefits. We therefore propose to prospectively examine the incidence of adverse events, as well as the clinical long-term effects of ultrasound-guided cervical medial branch blocks, in a cohort of pain clinic patients undergoing these procedures as part of their usual care.

Inclusion Criteria:

• Consenting patients over 18 years of age undergoing cervical medial branch blocks as part of their usual care and who have a pain intensity of at least 5/10 (at rest or on movement) and a pain duration of at least 4 months.

Exclusion Criteria:

• Inability to communicate or complete follow up questionnaires
• Known bleeding disorder or coagulopathy
• Patients on antiplatelet medication other than aspirin and those on anticoagulants (coumadin, AT III agents)
• Inability to visualize targeted structures on ultrasound
• Presence of acute radiculopathy of new onset neurological symptoms in the upper extremities
• Patients with bilateral neck pain if only one side is treated

Patients presenting to a tertiary outpatient pain clinic for diagnosis and treatment of chronic neck pain