The cervical facet joint capsules are larger and more lax than thoracic or lumbar facet capsules, reflecting the greater cervical range of motion. They contain the highest density of nociceptors of any cervical structure, making them the primary pain generator in whiplash and degenerative cervical facet disease. C2-C3 capsule involvement produces the cervicogenic headache characteristic of upper cervical facet injury.
| Origin | Articular processes of the cervical vertebrae |
|---|---|
| Insertion | Adjacent articular process capsule — the cervical facet capsules are the largest and most lax of the spinal facet capsules, allowing the greatest range of motion |
| Actions | Primary restraint of cervical facet motion in all planes; pain-sensitive (nociceptors and mechanoreceptors); the primary source of cervicogenic headache and neck pain after whiplash |
|---|
Cervical facet capsule injury from whiplash produces the chronic neck pain and headache that persists after typical soft tissue healing. Medial branch blocks target the nerve supply to the facet capsule at each level. Two positive blocks at the same level (>50% relief each) qualify patients for radiofrequency neurotomy — which denervates the facet capsule for 12-24 months of relief.
Cervical facet capsule strain from hyperextension-flexion mechanism producing chronic neck pain managed with medial branch blocks and RF neurotomy.
