Systematic Reviews
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. May 18, 2016; 7(5): 315-337
Published online May 18, 2016. doi: 10.5312/wjo.v7.i5.315
Management of lumbar zygapophysial (facet) joint pain
Laxmaiah Manchikanti, Joshua A Hirsch, Frank J E Falco, Mark V Boswell
Laxmaiah Manchikanti, Pain Management Center of Paducah, Paducah, KY 42003, United States
Laxmaiah Manchikanti, Mark V Boswell, Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY 40292, United States
Joshua A Hirsch, NeuroInterventional Services and Neuroendovascular Program, Massachusetts General Hospital, Boston, MA 02114, United States
Joshua A Hirsch, Harvard Medical School, Boston, MA 02115, United States
Frank J E Falco, Mid Atlantic Spine and Pain Physicians, Newark, DE 19702, United States
Frank J E Falco, Pain Medicine Fellowship Program, Temple University Hospital, Philadelphia, PA 19140, United States
Author contributions: Manchikanti L, Hirsch JA, Falco FJE and Boswell MV contributed to this work; Manchikanti L and Boswell MV designed the research; Manchikanti L and Falco FJE performed the research; Manchikanti L and Hirsch JA contributed new reagents/analytic tools, analyzed the data and wrote the paper; all authors reviewed all contents and approved for submission.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.
Data sharing statement: There is no such statement required. This manuscript has not described any basic research or clinical research.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Laxmaiah Manchikanti, MD, Medical Director of the Pain Management Center of Paducah, Clinical Professor, Pain Management Center of Paducah, 2831 Lone Oak Road, Paducah, KY 42003, United States. drlm@thepainmd.com
Telephone: +1-270-5548373-101 Fax: +1-270-5548987
Received: June 9, 2015
Peer-review started: June 11, 2015
First decision: September 30, 2015
Revised: January 14, 2016
Accepted: January 27, 2016
Article in press: January 29, 2016
Published online: May 18, 2016
Core Tip

Core tip: This review summarizes diagnostic and therapeutic aspects of chronic low back pain of facet joint origin. Even though multiple high quality diagnostic accuracy studies are available, there is room for further studies to confirm accuracy. These studies are key for the universal acceptance of facet joint nerve blocks of the lumbosacral spine as the gold standard. Deficiencies continue with therapeutic interventions. Lumbar radiofrequency neurotomy studies have shown contradicting results with short-term follow-ups. There is limited high quality literature for lumbar facet joint nerve blocks, and the available literature contains contradictory findings in multiple trials of intraarticular injections.