12. Pain Originating from the Lumbar Facet Joints

摘要: Although the existence of a "facet syndrome" had long been questioned, it is now generally accepted as clinical entity. Depending on diagnostic criteria, zygapophysial joints account for between 5% and 15% cases chronic, axial low back pain. Most commonly, facetogenic pain result repetitive stress and/or cumulative low-level trauma, leading to inflammation stretching joint capsule. The most frequent complaint with referred perceived in flank, hip, thigh. No physical examination findings are pathognomonic diagnosis. strongest indicator lumbar facet reduction after anesthetic blocks rami mediales (medial branches) dorsales that innervate joints. Because false-positive and, possibly, false-negative results may occur, must be interpreted carefully. In patients injection-confirmed pain, procedural interventions can undertaken context multidisciplinary, multimodal treatment regimen includes pharmacotherapy, therapy regular exercise, if indicated, psychotherapy. Currently, "gold standard" treating radiofrequency (1 B+). evidence supporting intra-articular corticosteroids limited; hence, this should reserved those individuals who do not respond (2 B±).