Cervical Epidural Block in Chronic Neck Pain

Chronic neck pain can negatively affect daily activities, work ability, and quality of life. Cervical epidural block is commonly used to reduce pain and inflammation, while exercise and physical therapy aim to improve muscle strength, endurance, movement control, and physical function. However, there is limited evidence comparing cervical epidural block alone with its combined use with exercise or physical therapy. This study aims to compare the effects of three treatment approaches in patients with chronic neck pain associated with cervical disc pathology or degenerative changes. Participants will receive cervical epidural block alone, cervical epidural block combined with cervical stabilization exercises, or cervical epidural block combined with physical therapy. Pain intensity, neck-related disability, and quality of life will be evaluated before treatment and at 1, 3, and 6 months after treatment using the Numeric Rating Scale, Neck Disability Index, and 12-Item Short Form Health Survey. The study will determine whether adding exercise or physical therapy to cervical epidural block provides additional clinical and functional benefits.

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