ChiroACCESS Clinical Review



Lumbar Facet Pain: Therapy

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Lead Author(s): 

Dwain M. Daniel, D.C.

  

How this evidence was rated:

Strength of Recommendation Taxonomy (SORT)



Published on

August 11, 2008

Text Size:     
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 (1). 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.

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References

1. 

Bryant S, Atkins B, Bull P. Demographics and diagnostic profile of patients presenting to a university chiropractic outpatient clinic. Chiro J Aust 2003;33(3):89-92.



2. 

Hayden JA, Mior SA, Verhoef MJ. Evaluation of chiropractic management of pediatric patients with low back pain: a prospective cohort study. J Manipulative Physiol Ther 2003 Jan;26(1):1-8.



3. 

Cox JM, Feller JA. Chiropractic treatment of low back pain: A multicenter descriptive analysis of presentation and outcome in 424 consecutive cases. JNMS 1994;2(4):178-90.



4. 

Dreyfuss P, Horne M. MUJA: Manipulation under joint anesthesia/analgesia; A treatment approach for recalcitrant low back pain of synovial joint origin. J Manipulative Physiol Ther 1995;18(8).



5. 

Gose EE, Naguszewski WK, Naguszewski RK. Vertebral axial decompression therapy for pain associated with herniated or degenerated discs or facet syndrome: An outcome study. Neurol Res 1998;20:186-90.



6. 

Irwin RW, Zuhosky JP, Sullivan WJ, Foye PM, Sable AW, Panagos A. Industrial medicine and acute musculoskeletal rehabilitation. 5. Interventional procedures for work-related lumbar spine conditions. Arch Phys Med Rehabil 2007 Mar;88(3 Suppl 1):S22-S28.



7. 

Gofeld M, Jitendra J, Faclier G. Radiofrequency denervation of the lumbar zygapophysial joints: 10-year prospective clinical audit. Pain Physician 2007 Mar;10(2):291-300.



8. 

Friedly J, Chan L, Deyo R. Increases in lumbosacral injections in the Medicare population: 1994 to 2001. Spine 2007 Jul 15;32(16):1754-60.



9. 

Niemisto L, Kalso E, Malmivaara A, Seitsalo S, Hurri H. Radiofrequency denervation for neck and back pain: a systematic review within the framework of the cochrane collaboration back review group. Spine 2003 Aug 15;28(16):1877-88.



10. 

Manchikanti L, Singh V, Vilims BD, Hansen HC, Schultz DM, Kloth DS. Medial branch neurotomy in management of chronic spinal pain: systematic review of the evidence. Pain Physician 2002 Oct;5(4):405-18.



11. 

Cohen SP, Raja SN. Pathogenesis, diagnosis, and treatment of lumbar zygapophysial (facet) joint pain. Anesthesiology 2007 Mar;106(3):591-614.



12. 

Lilius G, Laasonen EM, Myllynen P, Harilainen A, Gronlund G. Lumbar facet joint syndrome. A randomised clinical trial. J Bone Joint Surg Br 1989 Aug;71(4):681-4.



13. 

Nelemans PJ, deBie RA, deVet HC, Sturmans F. Injection therapy for subacute and chronic benign low back pain. Spine 2001 Mar 1;26(5):501-15.



14. 

Bani A, Spetzger U, Gilsbach JM. Indications for and benefits of lumbar facet joint block: analysis of 230 consecutive patients. Neurosurg Focus 2002 Aug 15;13(2):E11.



15. 

Manchikanti L, Manchikanti KN, Manchukonda R, Cash KA, Damron KS, Pampati V, et al. Evaluation of lumbar facet joint nerve blocks in the management of chronic low back pain: preliminary report of a randomized, double-blind controlled trial: clinical trial NCT00355914. Pain Physician 2007 May;10(3):425-40.



16. 

Schulte TL, Pietila TA, Heidenreich J, Brock M, Stendel R. Injection therapy of lumbar facet syndrome: a prospective study. Acta Neurochir (Wien ) 2006 Nov;148(11):1165-72.



17. 

Fuchs S, Erbe T, Fischer HL, Tibesku CO. Intraarticular hyaluronic acid versus glucocorticoid injections for nonradicular pain in the lumbar spine. J Vasc Interv Radiol 2005 Nov;16(11):1493-8.



18. 

Cleary M, Keating C, Poynton AR. Viscosupplementation in lumbar facet joint arthropathy: a pilot study. J Spinal Disord Tech 2008 Feb;21(1):29-32.