Radiofrequency Treatment of Facet-related Pain: Evidence and Controversies

Jan Van Zundert*, Pascal Vanelderen, Alfons G. Kessels, Maarten van Kleef

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

31 Citations (Web of Science)

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.
Original languageEnglish
Pages (from-to)19-25
JournalCurrent Pain and Headache Reports
Volume16
Issue number1
DOIs
Publication statusPublished - Feb 2012

Keywords

  • Facet joints
  • Zygapophyseal joints
  • Low back pain
  • Diagnostic block
  • Medial branch block
  • Radiofrequency treatment
  • Evidence rating
  • Pain management

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