A Case Story From a Pain Specialist :
Chronic Neck Pain That Improved With the Right Diagnosis and Treatment
As a pain specialist, I’ve met many patients living with chronic pain for years without knowing the real cause.
One memorable case is Ms. Pornpan, a 57-year-old HR officer who had struggled with neck pain for almost five years.
How the Pain Affected Her Life
When she first came to see me, she described daily neck pain—especially in the mornings when her neck felt stiff and difficult to move.
Tilting her head backward caused sharp pain that radiated to her shoulder and shoulder blade.
She couldn’t sleep well, changed pillows constantly, avoided driving long distances, and even simple housework became difficult.
She had already tried multiple medications. Each time the relief lasted only 1–2 days.
Step-by-Step Diagnosis
The doctor began with a detailed history taking and physical examination to assess her range of motion, areas of tenderness, and neurological function. An X-ray of the cervical spine was then performed.
The X-ray revealed cervical facet joint arthropathy at the C5–7 levels, which correlated well with her symptoms.
Equally important, there was significant muscle tightness and spasm around the neck, shoulders, and scapular region.
These muscular issues were acting as persistent pain triggers, contributing to recurrent symptoms and chronic pain that had lasted for more than five years.
Choosing the Right Treatment
In this case, the doctor decided to perform Trigger Point Injection to help relieve the muscle tightness that was contributing to her pain.
The procedure was minimally invasive, took only a short time, required no hospital admission, and allowed her to return to daily activities as usual afterward.
Ms. Pornpan was initially anxious about undergoing the procedure, as she had already tried more than 5–10 different treatment methods without significant improvement. However, she eventually decided to proceed with Trigger Point Injection treatment.
Her Results After Treatment
After treatment, her neck pain improved significantly within the first two weeks. She was able to sleep better, return to daily activities, and gradually resume light exercise.
The doctor and physical therapy team closely monitored her progress to ensure proper recovery and help restore her confidence in using her body again.
She also continued with physical therapy, focusing on:
Strengthening the neck and scapular muscles
Improving joint mobility
Correcting posture and movement patterns in daily life
At her 6-month follow-up, her pain had improved by more than 90%, allowing her to return to a near-normal lifestyle.
If You Don’t Want Trigger point injection, What Else Helps?
Cervical facet joint degeneration cannot always be treated with surgery. For patients who are not comfortable with Trigger Point Injection, there are still several conservative approaches that doctors commonly recommend, which may help improve symptoms to some extent.
Improve posture during work and daily activities
Adjust the height of the desk, chair, and monitor appropriately
Avoid prolonged neck flexion, especially while using mobile phones
Change positions and move regularly every 30–45 minutes
Strengthen the neck and scapular muscles
The muscle groups that doctors usually focus on include:
Scapular stabilizers
Deep neck flexor and lateral neck muscles
Core muscles
When these muscle groups become stronger, the cervical joints are subjected to less stress, which often helps reduce pain significantly.
Maintain a healthy body weight
Excess body weight is associated with chronic neck and back pain. Maintaining an appropriate weight can help reduce stress on the spine and joints.
Use medication only during symptom flare-ups
Medication is typically used only for short-term symptom control under medical supervision, rather than as a long-term daily treatment.
Participate in appropriate physical therapy
In these cases, shockwave therapy or PMS therapy is usually not the primary recommendation, as those modalities are generally more suitable for tendon-related conditions.
Instead, treatment commonly focuses on relieving pain and slowing the progression of cervical joint degeneration through:
Manual therapy
Strengthening programs
Postural retraining and movement correction in daily activities
Some patients may experience significant improvement when these treatments are performed consistently.
A Message to Anyone With Chronic Neck Pain
This case shows that even long-standing neck pain can improve dramatically when we identify the true source and choose evidence-based treatment.
Most importantly:
Accurate assessment + proper foundational care
are the keys to long-term improvement.
I hope this story helps others understand their condition better and feel more confident about seeking the right care.
