Lumbar Facet Pain




Review Sections

Lumbar Facet Pain Icon    Lumbar Facet Pain

Low Back Pain: Acute or chronic pain in the lumbar or sacral regions, which may be associated with musculo-ligamentous sprains and strains; intervertebral disk displacement; and other conditions.

Zygapophyseal Joint: The joint that occurs between facets of the interior and superior articular processes of adjacent vertebra.

Clinical Reviews

Lumbar Facet Pain: Prevention

Although the lumbar facet is well established as a pain generator, very little meaningful research has been performed to determine risk factors. To evaluate risk factors for lumbar facet mediated pain (LFMP), one needs to locate a population with this specific diagnosis. However this has proven difficult. Clinical diagnosis is very uncertain. The gold standard of diagnosis is a series of two facet blocks which limits study populations. As a result many of the studies available are observational, performed on animals or cadavers or are speculative in nature.

Lumbar Facet Pain: Diagnosis

Several different authors estimate that 15 to 45% of all chronic low back pain is lumbar facet mediated pain (LFMP). The “gold standard” for diagnosis, which is recognized by most experts, is a series of two facet blocks using anesthetics which are active for different periods of time. An initial block is given and if the patient receives a significant reduction of pain a second block is performed. If the second provides a longer period of relief then it is assumed the pain arises from the facet. It must be mentioned when Schulte et al reported on the outcomes of 21 studies of LFMP using injection therapy, radiofrequency therapy or cryorhizotomy only 50% of patients achieved successful outcomes. If the pain generator in these cases were the facet joints, why were the results not more impressive? It is possible that the gold standard may be better described as the “best standard available” but not quite golden.

Lumbar Facet Pain: Therapy

The difficulties of arriving at an accurate diagnosis for lumbar facet mediated pain (LFMP) were previously described in the diagnosis section of this monograph. These difficulties lead to critical shortcomings in the process of determining the best course of treatment available. Very few studies, if any, relating to conservative care have provided the method used to arrive at an accurate diagnosis. An example of this weakness is found in a 2003 study on the diagnostic profiles of 1018 patients. Although lesions of the vertebral facet constituted 47% of the diagnoses, diagnostic procedures were not reported in this study. One must be sure an accurate diagnosis was made when one is evaluating the efficacy of a therapy. Consequently, all studies on conservative treatments were given C ratings due to this shortcoming.

Medical Subject Heading (MeSH) Information

MeSH Term: Low Back Pain

Scope Note: Acute or chronic pain in the lumbar or sacral regions, which may be associated with musculo-ligamentous SPRAINS AND STRAINS; INTERVERTEBRAL DISK DISPLACEMENT; and other conditions.

MeSH Synonyms:
  • Low Back Pain
  • Back Pain, Low
  • Back Pains, Low
  • Low Back Pains
  • Pain, Low Back
  • Pains, Low Back
  • Lumbago
  • Lower Back Pain
  • Back Pain, Lower
  • Back Pains, Lower
  • Lower Back Pains
  • Pain, Lower Back
  • Pains, Lower Back
  • Low Back Ache
  • Ache, Low Back
  • Aches, Low Back
  • Back Ache, Low
  • Back Aches, Low
  • Low Back Aches
  • Low Backache
  • Backache, Low
  • Backaches, Low
  • Low Backaches
  • Low Back Pain, Postural
  • Postural Low Back Pain
  • Low Back Pain, Posterior Compartment
  • Low Back Pain, Recurrent
  • Recurrent Low Back Pain
  • Low Back Pain, Mechanical
  • Mechanical Low Back Pain
Applicable MeSH Subheadings:
  • analysis
  • anatomy and histology
  • blood
  • cerebrospinal fluid
  • chemically induced
  • classification
  • complications
  • congenital
  • diagnosis
  • diagnostic imaging
  • drug therapy
  • economics
  • embryology
  • enzymology
  • epidemiology
  • ethnology
  • etiology
  • genetics
  • history
  • immunology
  • metabolism
  • microbiology
  • mortality
  • nursing
  • organization and administration
  • parasitology
  • pathology
  • physiology
  • physiopathology
  • prevention and control
  • psychology
  • radiotherapy
  • rehabilitation
  • statistics and numerical data
  • surgery
  • therapy
  • urine
  • veterinary
  • virology
See Related MeSH Terms: MeSH Term: Zygapophyseal Joint

Scope Note: The joint that occurs between facets of the interior and superior articular processes of adjacent VERTEBRAE.

MeSH Synonyms:
  • Zygapophyseal Joint
  • Joint, Zygapophyseal
  • Joints, Zygapophyseal
  • Zygapophyseal Joints
  • Facet Joint
  • Facet Joints
  • Joint, Facet
  • Joints, Facet
  • Zygapophysial Joint
  • Joint, Zygapophysial
  • Joints, Zygapophysial
  • Zygapophysial Joints
Applicable MeSH Subheadings:
  • abnormalities
  • anatomy and histology
  • blood supply
  • chemistry
  • cytology
  • diagnosis
  • diagnostic imaging
  • drug effects
  • embryology
  • etiology
  • growth and development
  • immunology
  • injuries
  • innervation
  • metabolism
  • microbiology
  • pathology
  • physiology
  • physiopathology
  • radiation effects
  • surgery
  • therapy
  • transplantation
  • ultrastructure
  • virology

Informative Links

Arrow Back Pain Information

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MedlinePlus: Back Pain

MedlinePlus will direct you to information to help answer health questions. MedlinePlus brings together authoritative information from NLM, the National Institutes of Health (NIH), and other government agencies and health-related organizations.

Current Clinical Trials Relating to  Low Back Pain AND Zygapophyseal Joint Provides patients, family members, and members of the public easy and free access to information on clinical studies for a wide range of diseases and conditions.


Facet Wedge Post Market Study

(Status: Active, not recruiting)

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