In chronic neck pain, there is no solid evidence that the use of the following is effective: traction, use of cervical collar, TENS, acupuncture, botulinum toxin injections, conventional physical therapy, and manipulation therapy. Exercises appear to be as effective as manual therapy or physical therapy in reducing pain. There is evidence that percutaneous radiofre-quency neurotomy for cervical facet pain provides pain relief for chronic neck pain. Pain from the facet joints can be diagnosed by diagnostic blocks of the medial branches that innervate the joints.
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