Neck (Cervical)
Cervical Facet Syndrome
경추 후관절 증후군
Axial neck pain from degeneration or inflammation of cervical facet joints
- How common
- Common (25–55% of chronic neck pain)
- Typical age
- Ages 40+
What is it?
Cervical zygapophyseal (facet) joint cartilage degeneration, synovitis, and capsular thickening cause local and referred pain.
Commonly affected: C2-3 and C5-6 facets most commonly affected
How it develops
- Repetitive Facet LoadPoor posture and repetitive motion overload facets
- Cartilage DegenerationCartilage wear and joint space narrowing
- SynovitisSynovium inflames, capsule swells
- Axial + Referred PainAxial neck pain with shoulder/scapular referral
Symptoms
- Axial Neck PainDeep, aching central/lateral neck pain
- Extension-WorsenedWorse with neck extension
- Scapular ReferralDull pain over shoulder/scapula
- Morning StiffnessMorning stiffness, loosens with movement
How it is examined
- Facet TendernessTenderness over affected facet
- Spurling NegativeRules out nerve root compression
- Extension-Rotation PainPain with combined extension-rotation
- Medial Branch BlockPain relief with medial branch block confirms
Imaging
Oblique X-ray shows facet degeneration and osteophytes.
- Facet joint space narrowing
- Subchondral sclerosis
- Osteophyte formation
MRI assesses synovial edema and capsular thickening.
- Facet effusion
- Capsular edema
- Associated disc changes
Non-surgical care
- Posture/ErgonomicsImprove monitor height and phone-use posture
- NSAIDs + HeatNSAIDs with heat or ultrasound therapy
- PT + ExerciseDeep neck flexor and isometric strengthening
- Facet Injection / MBBIntra-articular steroid or medial branch block
Conservative options are generally tried first. Medications listed here can have side effects — discuss them with your prescriber.
When surgery is considered
Failed conservative care; ≥80% pain relief with diagnostic block
Procedures that may be discussed
- Radiofrequency ablation of medial branch
- Rarely, facet fusion
Outlook
Most respond to conservative care; RFA provides 6–12 months of relief.