Published online Aug 28, 2015. doi: 10.4329/wjr.v7.i8.194
Peer-review started: January 29, 2015
First decision: March 6, 2015
Revised: April 17, 2015
Accepted: May 16, 2015
Article in press: July 8, 2015
Published online: August 28, 2015
Intervertebral disc degeneration and facet joint osteoarthritis of the lumbar spine are, among others, well known as a cause of low back and lower extremity pain. Together with their secondary disorders they set a big burden on health care systems and economics worldwide. Despite modern imaging modalities, such as magnetic resonance imaging, for a large proportion of patients with low back pain (LBP) it remains difficult to provide a specific diagnosis. The fact that nearly all the lumbar structures are possible sources of LBP, may serve as a possible explanation. Furthermore, our clinical experience confirms, that imaging alone is not a sufficient approach explaining LBP. Here, the Oswestry Disability Index, as the most commonly used measure to quantify disability for LBP, may serve as an easy-to-apply questionnaire to evaluate the patient’s ability to cope with everyday life. For therapeutic purposes, among the different options, the lumbar facet joint intra-articular injection of corticosteroids in combination with an anaesthetic solution is one of the most frequently performed interventional procedures. Although widely used the clinical benefit of intra-articular steroid injections remains controversial. Therefore, prior to therapy, standardized diagnostic algorithms for an accurate assessment, classification and correlation of degenerative changes of the lumbar spine are needed.
Core tip: Low back pain, caused by intervertebral disc degeneration (IDD) and facet joint osteoarthritis (FJOA), is a widely spread musculoskeletal disorder in all ages worldwide. Although IDD and FJOA are common findings on lumbar magnetic resonance-imaging, the relationship between imaging findings and clinical pain-presentation as well as the benefit of different therapeutic options often remains unclear. This article briefly reviews the correlation of IDD and FJOA with clinical pain scores and discusses possible treatment options of FJOA with focus on the intra-articular injection of corticosteroids.