The purpose of this article is to review nonoperative 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 vs. intra-articular (IA) LFJ injections using corticosteroids.
A systematic search of databases included PubMed and Google Scholar. Search terms included low back pain, facet joint dysfunction, injection, corticosteroid, and RF. The search resulted in several hundred results. An advanced MeSH term search was then used to limit the effect to within the past 10 years with variations of the terms mentioned above to further narrow the results to address the clinical question which resulted in 94 citations.
There were satisfactory results using PubMed Advanced Search Builder to include several comparative systematic reviews and randomized controlled trials. Excluded were studies that were broad in their comparisons, including those which included treatments with physical activity modifications, oral medications, physiotherapy, and chiropractic manipulation.
Studies suggest that there is a moderate amount of improvement in the short-term (less than 6 months) for both IA LFJ injections using corticosteroids and LFJ RF ablation; however, the RF ablation had better results for the middle (6 to 12 months) to long-term (greater than 12 months). The results established by the author's review suggest that although LFJ RF ablation and IA LFJ injections using corticosteroids are equally effective in the short-term pain management of patients with CLBP, RF is the more effective treatment for long-term pain management in patients with CLBP related to facet joint dysfunction.