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 and several rounds of physiotherapy.
Each time the relief lasted only 1–2 days.
Step-by-Step Diagnosis
I started with a detailed history and physical examination, looking at movement, tender points, and nerve function.
Her cervical X-ray showed facet joint arthropathy at C5–7, which matched her symptoms.
To confirm the exact pain source, I performed a diagnostic medial branch block (injecting local anesthetic to the sensory nerves of the joints).
Her pain disappeared immediately — the first pain-free hour she had had in five years.
I explained that this effect would last only briefly because this injection is for diagnosis, not long-term treatment.
Choosing the Right Treatment
For her condition, Radiofrequency Ablation (RFA) is a well-supported, standard treatment used worldwide for cervical facet joint degeneration pain.
The procedure takes 20–30 minutes and does not require hospital admission.
Although she was hesitant—after trying 5–10 other treatments without success—she eventually decided to proceed with RFA.
Her Results After Treatment
Within two weeks, her neck pain improved significantly.
She slept better, regained confidence in daily activities, and started light exercises again.
Along with RFA, she worked closely with our physiotherapy team to strengthen the stabilizing muscles around the neck and shoulder blade.
At her six-month follow-up, her pain had improved by over 90%, and she was back to near-normal life.
If You Don’t Want RFA, What Else Helps?
Neck facet joint degeneration cannot be cured with surgery.
But for patients who prefer not to undergo RFA, several non-procedural approaches can still help reduce symptoms:
1) Posture and workspace adjustments
- Correct desk, chair, and monitor height
- Avoid long periods of neck flexion (especially mobile phones)
- Change positions every 30–45 minutes
2) Targeted strengthening exercises
Focusing on:
- Scapular stabilizers
- Deep neck muscles
- Core muscles
Stronger muscles reduce load on the cervical joints and often improve symptoms.
3) Weight management
Keeping weight within a healthy range reduces stress on the spine and joints.
4) Using medication only during flare-ups
Short-term use under medical supervision—never as a daily solution.
5) Appropriate physiotherapy
Rather than shockwave or magnetic stimulation (more suitable for tendon problems), I emphasize:
- Manual therapy
- Strengthening programs
- Posture retraining
Many patients improve significantly when they follow these 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.
