Open AccessLumbar Facet Joint Nerve Blocks in Managing Chronic Facet Joint Pain: One-Year Follow-up of a Randomized, Double-Blind Controlled Trial: Clinical Trial NCT00355914
Author(s) -
Laxmaiah Manchikanti,
Sanjiv Singh,
Falco Fj,
Cash Ka,
Pampati
Publication year - 2008
Publication title -
pain physician
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.31
H-Index - 99
eISSN - 2150-1149
pISSN - 1533-3159
DOI - 10.36076/ppj.2008/11/121
Subject(s) - medicine , facet joint , oswestry disability index , lumbar , facet (psychology) , low back pain , local anesthetic , randomized controlled trial , anesthesia , neurotomy , chronic pain , interventional pain management , surgery , physical therapy , psychology , social psychology , alternative medicine , personality , pathology , big five personality traits
Background: Lumbar facet joints have been implicated as the source of chronic pain in15% to 45% of patients with chronic low back pain. Various therapeutic techniques including intraarticular injections, medial branch blocks, and radiofrequency neurotomy of lumbar facet joint nerves have been described in the alleviation of chronic low back pain of facet joint origin.Objective: The study was conducted to determine the clinical effectiveness of therapeuticlocal anesthetic lumbar facet joint nerve blocks with or without steroid in managing chronicfunction-limiting low back pain of facet joint origin.Design: A randomized, double-blind, controlled trial.Setting: An interventional pain management setting in the United States.Methods: This study included 60 patients in Group I with local anesthetic and 60 patientsin Group II with local anesthetic and steroid. The inclusion criteria was based on the positive response to the diagnostic controlled comparative local anesthetic lumbar facet jointblocks.Outcome measures: Numeric pain scores, Oswestry Disability Index, opioid intake, andwork status. All outcome assessments were performed at baseline, 3 months, 6 months,and 12 months.Results: Significant improvement with significant pain relief (> 50%) and functional improvement (> 40%) were observed in 82% and 85% in Group I, with significant pain reliefin over 82% of the patients and improvement in functional status in 78% of the patients.Based on the results of the present study, it appears that patients may experience significantpain relief 44 to 45 weeks of 1 year, requiring approximately 3 to 4 treatments with an average relief of 15 weeks per episode of treatment.Conclusion: Therapeutic lumbar facet joint nerve blocks, with or without steroid, may provide a management option for chronic function-limiting low back pain of facet joint origin.Key words: Chronic low back pain, lumbar facet or zygapophysial joint pain, facet jointnerve or medial branch blocks, comparative controlled local anesthetic blocks, therapeuticlumbar facet joint nerve blocks