Table 6

Studies evaluating the association between cervical plain film imaging pathology and facet pain

Author, yearPatient populationDesignResultsComments
Rudy et al 201584322 pts with neck stiffness, shoulder pain, arm pain and/or headache attending chiropractic teaching clinics with cervical radiographsRetrospective cross-sectional studySymptoms of neck pain, headaches, referral of pain to the shoulder, and upper extremity radiculopathy did not correlate with cervical facet joint degenerationConvenience sample with no asymptomatic comparison group.
Small association between neck stiffness and facet hypertrophy
Van der Donk et al 1991175440 volunteers 20–65 years of age enrolled in a national survey study stratified by presence of neck painCross-sectional survey studyOsteoarthritis of the facet joints noted on cervical radiographs was not associated with neck painMean age of participants was 46 years.
Age was positively associated with neck pain
Gore et al 198783205 pts with neck pain >10 years durationRetrospectivePresence or severity of pain was not associated with the presence of degenerative changes including facet arthropathy, sagittal diameter of the spinal canal, or degree of cervical lordosis on initial or final cervical x-ray68 of 205 (33%) were involved in litigation.
Mean age at onset of neck pain was 43 years; mean age at final evaluation was 58 years.
Heller et al 198382653 case pts were referred for cervical spine x-ray. 365 control pts who were referred for barium studies received cervical spine x-raysRetrospective case–controlNo significant difference in the presence of cervical spondylosis between groups. There were no significant associations between neck, arm, or occipital pain, and neck stiffness with x-ray findingsCervical spondylosis was positively correlated with age