Radiofrequency Treatment of Facet-Related Pain: Evidence and Controversies

Curr Pain Headache Rep. 2012 Feb;16(1):19-25. doi: 10.1007/s11916-011-0237-8.

Abstract

Pain originating from the lumbar facet joints is estimated to represent about 15% of all low back pain complaints. The diagnostic block is considered to be a valuable tool for confirming facetogenic pain. It was demonstrated that a block of the ramus medialis of the ramus dorsalis is preferred over an intra-articular injection. The outcome of the consequent radiofrequency treatment is not different in patients reporting over 80% pain relief after the diagnostic block than in those who have between 50% and 79% pain relief. There is one well-conducted comparative trial assessing the value of one or two controlled diagnostic blocks to none. The results of the seven randomized trials on the use of radiofrequency treatment of facet joint pain demonstrate that good patient selection is imperative for good clinical outcome. Therefore, we suggest one block of the ramus medialis of the ramus dorsalis before radiofrequency treatment.

Publication types

  • Review

MeSH terms

  • Catheter Ablation* / methods
  • Female
  • Humans
  • Injections, Intra-Articular / methods*
  • Low Back Pain / drug therapy
  • Low Back Pain / etiology
  • Low Back Pain / physiopathology
  • Low Back Pain / surgery*
  • Male
  • Nerve Block / methods*
  • Patient Satisfaction
  • Patient Selection
  • Preoperative Care / methods*
  • Quality of Life
  • Treatment Outcome
  • Zygapophyseal Joint / drug effects
  • Zygapophyseal Joint / innervation
  • Zygapophyseal Joint / physiopathology
  • Zygapophyseal Joint / surgery*