Clinical features of patients with pain stemming from the lumbar zygapophysial joints. Is the lumbar facet syndrome a clinical entity?

Spine (Phila Pa 1976). 1994 May 15;19(10):1132-7. doi: 10.1097/00007632-199405001-00006.


Study design: This study is a prospective cross-sectional analytic study.

Objectives: The authors determined the prevalence and clinical features of patients with pain stemming from the lumbar zygapophysial joints.

Summary of background data: Previous studies have demonstrated a wide range of prevalence for zygapophysial joint pain and conflicting results with regard to clinical signs.

Methods: One hundred and seventy-six consecutive patients with chronic low back pain were investigated with a series of screening zygapophysial joint blocks using lignocaine and confirmatory blocks using bupivacaine.

Results: Forty-seven percent of patients had a definite or greater response to the screening injection at one or more levels but only 15% had a 50% or greater response to a confirmatory block. Response to zygapophysial joint injection was not associated with any single clinical feature or set of clinical features.

Conclusions: The zygapophysial joint is an important source of pain but the existence of a "facet syndrome" must be questioned.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bupivacaine
  • Cross-Sectional Studies
  • Female
  • Humans
  • Injections, Intra-Articular
  • Lidocaine
  • Logistic Models
  • Low Back Pain / diagnosis
  • Low Back Pain / epidemiology
  • Low Back Pain / etiology*
  • Lumbar Vertebrae / innervation*
  • Male
  • Nerve Block
  • Physical Examination
  • Prevalence
  • Prospective Studies
  • Syndrome


  • Lidocaine
  • Bupivacaine