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Synovial folds - a pain in the neck?

Webb, Alexandra L., Collins, Patricia, Rassoulian, Hamid and Mitchell, Barry S. (2011) Synovial folds - a pain in the neck? Manual Therapy, 16, (2), pp. 118-124. (doi:10.1016/j.math.2010.11.004). (PMID:21216653).

Record type: Article


The synovial folds of the cervical spine are regarded as a potential source of neck pain and headache, especially following whiplash injury. Damage to the synovial folds following motor vehicle trauma has been well documented in post-mortem studies. However, methods of identifying injury to the synovial folds in the survivors of motor vehicle trauma have proven elusive to date. Recently, it has been made possible to image the synovial folds in vivo using magnetic resonance imaging. This now makes it feasible to investigate the potential involvement of synovial folds in the generation of neck pain and headache and its relief using spinal manipulation. This paper reviews critically the morphology of the synovial folds of the cervical spine that underpins the hypotheses proposed to explain their functional and clinical significance and a new system of naming and classifying the synovial folds is presented. Although there is some evidence to support the contribution of the synovial folds to neck pain, several theories have little or no support and require investigation and further evaluation. These findings have implications for understanding the anatomical basis of neck pain and headache and the rationale for the use of spinal manipulation in their management.

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Published date: April 2011
Keywords: synovial folds, cervical spine, neck pain, manipulation


Local EPrints ID: 170717
ISSN: 1356-689X
PURE UUID: 579543e9-ad19-4acf-a3b8-2b2376782781

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Date deposited: 10 Jan 2011 12:42
Last modified: 18 Jul 2017 12:16

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Author: Alexandra L. Webb
Author: Patricia Collins
Author: Hamid Rassoulian
Author: Barry S. Mitchell

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