Newswise — About 1 out of every 4 cases of chronic low back pain is due to problems from the lumbar facets, which are small segmental joints at each level of the lumbar spine. Facets stabilize the spine and assist with load bearing. While pain originating from the facets may be due to degeneration, the exact mechanisms or trigger events leading to this problem remain unknown.
A research group at Johns Hopkins sought to identify whether specific events precede this problem, categorize those events, and determine whether any specific events correlate with treatment outcomes. Their research showed that, out of 1,069 patients, more than half (52%) reported a specific event preceding their lumbar facet pain diagnosis.
The most commonly reported events were falls, motor vehicle collisions, and sports-related injuries. Patients who reported an inciting event, adults < 65 years old, and individuals with < 10 years of chronic low back pain were twice as likely to respond positively to radiofrequency ablation of the lumbar facet joints, compared to their peers.
The positive findings in patients who reported inciting events raises interesting questions regarding what role anxiety (due to uncertainty) versus certainty about the cause of pain may play in expectations of recovery and treatment response. Future research exploring the psychosocial aspects of patients’ perceptions about underlying precipitants of their pain may deepen the understanding of determinants of treatment response to radiofrequency ablation for lumbar facet pain.
The study “Identification of Precursor Events Associated with Lumbar Facet Joint Pain and Outcomes” by Charles Odonkor, Yian Chen, and Steven Cohen, will be presented at the 16th Annual Pain Medicine Meeting. The abstract was selected as a Best of Meeting Abstract and also has received an ASRA Resident/Fellow Travel Award. Primary author Charles Odonkor, MD, will present the findings on Thursday, November 16, at 10 am and on Friday, November 17, at 2:05 pm as part of the Resident/Fellow Educational Program.
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ASRA 16th Annual Pain Medicine Meeting, Nov-2017