Background: Lumbar facet joint pain is diagnosed by controlled diagnostic blocks. The accuracy
of controlled diagnostic blocks has been demonstrated in multiple studies and confirmed in
systematic reviews. Controlled diagnostic studies have shown an overall prevalence of lumbar
facet joint pain in 31% of the patients with chronic low back pain without disc displacement or
radiculitis, with an overall false-positive rate of 30% using a single diagnostic block.
Study Design: An observational report of outcomes assessment.
Setting: An interventional pain management practice setting in the United States.
Objective: To determine the accuracy of controlled diagnostic blocks in managing lumbar
facet joint pain at the end of 2 years.
Methods: This study included 152 patients diagnosed with lumbar facet joint pain using
controlled diagnostic blocks. The inclusion criteria was based on a positive response to
diagnostic controlled comparative local anesthetic lumbar facet joint blocks. The treatment
included therapeutic lumbar facet joint nerve blocks.
Outcome Measures: The sustained diagnosis of lumbar facet joint pain at the end of one
year and 2 years based on pain relief and functional status improvement.
Results: At the end of one year 93% of the patients and at the end of 2 years 89.5% of the
patients were considered to have lumbar facet joint pain.
Limitations: The study is limited by its observational nature.
Conclusion: Controlled diagnostic lumbar facet joint nerve blocks are valid utilizing the criteria
of 80% pain relief and the ability to perform previously painful movements, with sustained
diagnosis of lumbar facet joint pain in at least 89.5% of the patients at the end of a 2-year
follow-up period.
Key words: Chronic low back pain, lumbar facet or zygapophysial joint pain, facet joint
nerve or medial branch blocks, controlled local anesthetic blocks, construct validity, diagnostic
studies, diagnostic accuracy
Percutaneous CT-Guided Treatment of Lumbar Facet Joint Synovial Cysts