Introduction: Low back pain is one of the most common reasons for medical consultations. It is often a cause for physical limitation in patients above 45 years of age and it is the fifth most common cause for hospitalization. Patients with facet pain can be managed in several ways either by medical treatment, physiotherapy, facet injection or facet medial branch block by either chemical block or by radiofrequency.Our aim is to evaluate the effectiveness of chemical and thermal medial branch block in patients with chronic low back pain due to facet arthropathy
Methods: The study included 30 patients 15 in chemical (injection) group and 15 in thermal (radiofrequency) group. VAS, Revised Oswestry Disability index and need for analgesia were used to evaluate the outcomes. All outcome assessments were done baseline, 1month, 3 months, 6 months and 9 months post intervention.
Results: Medial branch radiofrequency was superior to medial branch injection on VAS score (P=0.01). And also for the functional outcome on revised Oswestry disability index (P=0.05). On early post procedure follow up both were effective for relief of facet pain but medial branch radiofrequency showed more prolonged relief. Medial branch radiofrequency showed more patient satisfaction than medial branch injection
Conclusions: Both medial branch injection and radiofrequency are easy, safe and effective treatment modalities for managing lumbar facet syndrome. Although medial branch radiofrequency is superior to medial branch injection, medial branch injection is cost effective than medial branch radiofrequency. It is the first choice to do injection and if there is recurrence of pain radiofrequency neurotomy would be chosen
Patient Care: Improve patient care by improving pain mangement outcome
Learning Objectives: To learn about different pain treatment techniques. To know the detailed methods of facet approach.to understand the roles of radioferquency neurotomy