University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository




Thomas Colletti, DHSc, MPAS, PA-C



Purpose: The purpose of this article is to review non-operative treatment for chronic low back pain (CLBP) related to facet joint dysfunction and to compare the long-term pain reduction and functional improvement with lumbar facet joint (LFJ) radiofrequency (RF) ablation versus intraarticular (IA) LFJ injections using corticosteroids.

Method: A systematic search of databases included PubMed and Google Scholar. Search terms included low back pain, facet joint dysfunction, injection, corticosteroid, and radiofrequency. The search resulted in several hundred results. An advanced MeSH term search was then used to limit the effect to within the last ten years with variations of the terms above to further narrow results to address the clinical question which, resulted in 94 citations.

Results: There were satisfactory results using PubMed Advanced Search Builder to include several comparative Systematic Reviews and Randomized Controlled Trials (RCTs). Excluded were studies that were broad in their comparisons, including those which included treatments with physical activity modifications, oral medications, physiotherapy, and chiropractic manipulation.

Conclusion: Studies suggest that there is a moderate amount of improvement, in the short term (less than six months) for both IA LFJ injections using corticosteroids and LFJ RF ablation; however, the RF ablation had better results for the middle (six-12 months) to long-term (greater than 12 months). The results established by the author’s review suggest that while LFJ RF ablation and IA LFJ injections using corticosteroids are equally effective in the short term-pain management of patients with CLBP, radiofrequency is the more effective treatment for long-term pain management in patients with CLBP related to facet joint dysfunction.

Keywords: Low Back Pain, Facet Joint Dysfunction, Facet Radiofrequency, Facet Joint Injection, Corticosteroids.


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