FRIDAY, Dec. 10, 2021 (HealthDay News) — The American Society of Regional Anesthesia and Pain Medicine and the American Academy of Pain Medicine charged a multinational, multispecialty panel of experts to develop neck pain guidelines; their recommendations are summarized in consensus practice guidelines published online Nov. 11 in Regional Anesthesia & Pain Medicine.

Robert W. Hurley, M.D., Ph.D., from the Wake Forest School of Medicine in Winston-Salem, North Carolina, and colleagues developed guidelines for the diagnosis and treatment of neck pain, including cervical spine joint procedures such as use of joint injections, nerve blocks, and radiofrequency ablation (RFA).

The researchers found that 14 of 20 questions that were selected were approved with no dissentions or abstentions. The group made the following recommendations, among others. In those with chronic neck pain, conservative treatment should be used prior to prognostic cervical facet blocks (grade B recommendation, moderate level of certainty). Image guidance with fluoroscopy or ultrasound should be used for cervical medial branch blocks (grade A recommendation, moderate level of certainty). Image guidance with fluoroscopy should be used before RFA (grade A recommendation, high level of certainty for imaging; grade B recommendation, moderate level of certainty for use of fluoroscopy). For diagnostic procedures, sedation should not routinely be given (grade B recommendation, moderate level of certainty). In the absence of extenuating circumstances, a single block should be used to select patients for RFA (grade B recommendation, low to moderate level of certainty).

“These multi-society guidelines have been developed to serve as a roadmap to improve outcomes, enhance safety, and minimize unnecessary tests and procedures,” the authors write.

Several authors disclosed financial ties to the biopharmaceutical and medical device industries.

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