• Dong-Gyu Lee, Yun-Woo Cho, Sung-Ho Jang, Su-Min Son, Gook-Joo Kim, and Sang-Ho Ahn.
• Department of Physical Medicine and Rehabilitation, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, South Korea.
• Pain Med. 2015 Jun 1;16(6):1077-82.

ObjectivesThe aims of this study were to evaluate the role of intra-articular joint injection for atlanto-occipital (AO) joint pain and to determine pain referral sites from that joint.DesignProspective observational study.MethodWe evaluated 29 patients with chronic refractory neck pain and/or headache, and limited range of lateral bending with rotation at the AO joint on physical examination. Of the 24 patients who consented to undergo diagnostic injections, 20 patients had at least 50% relief from pain and underwent two AO intra-articular injections of mixture of local anesthetic and steroid approximately 1 week apart. Patients completed pain drawings, visual analog scales (VASs) for pain, and neck disability index (NDI) for level of function. Patients were evaluated for 2 months after the first injection.ResultThere was headache in 14/20 (70%), posterior neck pain (PNP) in 20, and referred pain in 17 (85%). The average VAS values for headache, PNP, and other referred pains were reduced significantly from 5.64, 5.70, and 5.41, respectively, before treatments to 0.64, 2.30, and 1.71, respectively, two months after injection (P < 0.01). The average NDI value was reduced significantly from 39.95% at pretreatment to 20.40% at 2 months after treatment (P < 0.01).ConclusionAO intra-articular steroid injection appears effective for the short-term control of chronic refractory pain arising from the AO joint.Wiley Periodicals, Inc.

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