CERVICAL EPIDURAL BLOCK IN CHRONIC NECK PAIN

Chronic neck pain is a common musculoskeletal condition associated with limitations in daily activities, reduced work capacity, and impaired quality of life. Cervical disc degeneration and herniation are among the structural conditions that may contribute to persistent neck pain. Although education, medications, exercise, and physical therapy are commonly used as conservative treatments, symptoms may persist in some patients. Cervical epidural block is used in clinical practice to reduce pain and inflammation associated with cervical disc pathology.

Exercise and physical therapy may complement the effects of cervical epidural block by improving cervical muscle strength, endurance, neuromuscular control, and physical function. However, evidence directly comparing cervical epidural block alone with its combined use with cervical stabilization exercises or physical therapy is limited. This three-group study will compare the clinical and functional effects of these treatment approaches in patients with chronic neck pain associated with cervical disc pathology or degenerative changes. The findings may help determine whether adding exercise or physical therapy to cervical epidural block provides additional benefits and may guide treatment planning for patients with chronic neck pain.

Inclusion criteria

• Aged 18 to 55 years
• Neck pain lasting longer than 3 months
• Diagnosis of cervical radiculopathy
• Numeric Rating Scale (NRS) pain score of 5 or higher

Exclusion criteria

• History of spinal surgery
• Cervical spondylolisthesis
• Spinal stenosis
• Presence of a neurological deficit
• History of psychiatric disease
• Polyneuropathy
• History of spinal fracture
• Pregnancy
• History of malignancy
• Known allergy to any medication used in the study
• Central sensitization
• Widespread pain
• Regional pain associated with a systemic disease