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Finding Familiar Treatments for Unfamiliar Sources of Back Pain

Say zygapophysial. Zyga what? Now say this: low back pain. Now that's an all-too-familiar term. In many instances of low back pain, it's actually the zygapophysial joints that are causing the pain. These spinal joints are also known as facet joints. These flat, smooth-surfaced joints make it possible for us to twist, turn, bend, and straighten.

Researchers gathered available information on treating problem facet joints. They reviewed all of the articles on the topic. Their goal was to find out the best way to treat this condition and who gets the best results. They found studies focused on two areas of treatment: injections into the facet joint and radiofrequency (RF) to cut the nerve that goes to the problem joint.

The authors report that injections are good to help find the problem, but they don't usually work to solve the problem. Treatment with RF was more favorable. Each study reported a positive response to this form of treatment. Patients got pain relief that lasted. Cutting the nerve involved less time and cost than other treatments for painful facet joints. Even patients who had pain for five years or more got relief.

Not all the studies agreed. The researchers think that more (and better) studies are needed to sort out the best ways of treating painful facet joints.

References: Curtis W. Slipman, MD, et al. A Critical Review of the Evidence for the Use of Zygapophysial Injections and Radiofrequency Denervation in the Treatment of Low Back Pain. In The Spine Journal. July/August 2003. Vol. 3. No. 4. Pp. 310-316.

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