A Comparison of Intraarticular Lumbar Facet Joint Steroid Injections and Lumbar Facet Joint Radiofrequency Denervation in the Treatment of Low Back Pain

Lakemeier, Stefan; Lind, Marcel; Schultz, W.; Fuchs-Winkelmann, Susanne; Timmesfeld, Nina; Foelsch, Christian; Peterlein, Christian‐Dominik

doi:10.1213/ane.0b013e3182910c4d

Cited by 114 publications

(117 citation statements)

References 31 publications

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“…To date, there is controversy about the effectiveness of intra-articular steroid injections [6] . Recently, several studies were conducted to learn more about the clinical benefit of LFJ infiltration with glucocorticoids in comparison to alternative treatment options [7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

Does therapist’s attitude affect clinical outcome of lumbar facet joint injections?

Middendorp

Kollias

Ackermann

et al. 2016

WJR

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AIM:To investigate if the clinical outcome of intraarticular lumbar facet joint injections is affected by the therapist's attitude. METHODS:A total of 40 patients with facet jointassociated chronic low back pain were randomly divided into two groups. All patients received computed tomography-guided, monosegmental intra-articular facet joint injections. Following the therapeutic procedure, the patients of the experimental group (EG) Middendorp M et al . Influence of therapist's attitude on clinical outcome held a conversation with the radiologist in a comfortable atmosphere. During the dialog, the patients were encouraged to ask questions and were shown four images. The patients of the control group (CG) left the clinic without any further contact with the radiologist. Outcome was assessed using a pain-based Verbal Numeric Scale at baseline, at 1 wk and at 1, 3, and 6 mo after first treatment. RESULTS:The patient demographics showed no differences between the groups. The patients of the EG received 57 interventional procedures in total, while the patients of the CG received 70 interventional procedures. In both groups, the pain scores decreased significantly over the entire observation period. Compared to the CG, the EG showed a statistically significant reduction of pain at 1 wk and 1 mo post-treatment, while at 3 and 6 mo after treatment, there were no significant differences between both groups. CONCLUSION:Our results show a significant effect on pain relief during the early post-interventional period in the EG as compared to the CG. The basic principle behind the higher efficacy might be the phenomenon of hetero-suggestion. Core tip:The presented results show a significantly positive effect of the therapist's attitude on pain relief within the first month after facet joint intra-articular injections. Increased therapeutic efficacy seems to be evident in those patients who have a better understanding of therapies applied on them.

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Section: Introductionmentioning

confidence: 99%

Does therapist’s attitude affect clinical outcome of lumbar facet joint injections?

Middendorp

Kollias

Ackermann

et al. 2016

WJR

View full text Add to dashboard Cite

show abstract

“…The clinical features of this syndrome are localized back pain or neck pain worsened with extension, improved with extension, and diagnosed with facet blocks. Lumbar facet joint degeneration is a source of chronic low back pain, with an incidence of 15% to 45% among patients with low back pain [27]. On occasion, radiological studies may show facet hypertrophy.…”

Section: Introductionmentioning

confidence: 99%

“…A facet denervation is the treatment of choice. However, a recent publication reported that the efficacy of the steroid injection was equal to radiofrequency denervation [27] Another diagnosis overused by physicians who cannot accurately establish diagnosis is complex regional pain syndrome (CRPS) or reflex sympathetic dystrophy (RSD). Research shows that these patients have nothing more than undetected nerve entrapment syndrome 71%-80% of the time, and they respond to nerve decompression as their sole treatment [8,9].…”

Section: Introductionmentioning

confidence: 99%

Evaluating Chronic Pain Patients Using Methods from Johns Hopkins Hospital Physicians

Hendler¹

2016

J Pain Relief

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Chronic pain patients are misdiagnosed 40%-80% of the time, according to research from Johns Hopkins Hospital physicians. Methods to determine the validity of the complaint of pain, as well as clinical suggestions on methods to improve the accuracy of diagnosis and testing are summarized, as well as the description of an Internet based system which provides diagnoses with a 96% correlation with diagnoses of Johns Hopkins Hospital physicians.

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“…Lumbar facet joint degeneration is a source of chronic low back pain, with an incidence of 15 to 45% among patients with low back pain. 27 On occasion, radiological studies may show facet hypertrophy. One study reported in association between heavy physical activity and the development of CT confirmed lumbar zygapophyseal joint osteoarthritis.…”

mentioning

confidence: 99%

“…However, a recent publication reported that the efficacy of the steroid injection was equal to radiofrequency denervation. 27 Patients are mistakenly told that they have complex regional pain syndrome or reflex sympathetic dystrophy (RSD) at an unconscionably high rate. The clinical presentation of RSD requires circumferential pain (pain all around a limb), in combination with mechanical and thermal allodynia (a painful response to a normally nonpainful stimulus).…”

mentioning

confidence: 99%

Why Chronic Pain Patients are Misdiagnosed 40 to 80% of the Time?

Hendler¹

2016

Journal on Recent Advances in Pain

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Researchers from Johns Hopkins Hospital have reported that 40%-80% of chronic pain patients are misdiagnosed. The leading causes for these errors are a failure to take a thorough and comprehensive history from the patient, and ordering the wrong tests. Typical testing errors are the use of anatomical tests to detect the physiological phenomenon of chronic pain, and a failure to understand the specificity and sensitivity of medical testing commonly in use.

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A Comparison of Intraarticular Lumbar Facet Joint Steroid Injections and Lumbar Facet Joint Radiofrequency Denervation in the Treatment of Low Back Pain

Cited by 114 publications

References 31 publications

Does therapist’s attitude affect clinical outcome of lumbar facet joint injections?

Does therapist’s attitude affect clinical outcome of lumbar facet joint injections?

Evaluating Chronic Pain Patients Using Methods from Johns Hopkins Hospital Physicians

Why Chronic Pain Patients are Misdiagnosed 40 to 80% of the Time?

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