What is the efficacy of intra-articular facet blocks for the treatment of low back pain (LBP)?

Updated: Aug 22, 2018
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Answer

A retrospective evaluation by Lippitt showed initial relief in 50% of participants, but only 14% of participants claimed relief at 6 months, and only 8% at 12 months. [144] Lau et al, in a retrospective review, reported 56% with initial relief, 44% with continued relief at 3 months, and 35% after 6 months. [145]

Although some physicians advocate facet injections as a treatment method, a large prospective study [146] showed no long-term benefit. Boswell et al determined that there is moderate evidence for short- and long-term improvement in back pain managed with intra-articular injections of local anesthetic and corticosteroids. [136] However, an overall assessment of the literature suggests that intra-articular facet injections have dubious therapeutic value when used in isolation, unless they are targeted at a specific joint pathology, such as a facet cyst. Although opinions on, and the success rates of, facet injections vary widely as an isolated treatment (ie, without physical therapy or cognitive behavioral approaches), the use of intra-articular facet injections is widely supported as a diagnostic.


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