A Treatment Proven Not To Work, and Some Thoughts As To Why.
If you have suffered from lower back or neck pain for any length of time, you may have been given facet joint injections as a part of your treatment. Facet joint injections, are injections into the joints of the spine with a steroid to relieve pain. The theory behind these injections appears sound, since these joints are highly innervated with pain sensitive nerves, it would appear that injections would help. The second step in the injection process is to then ablate or deaden the nerves in the joint to prolong the pain relief. These nerves do however, grow back usually within 3-6 months.
While the rationale behind these injections makes some sense the medical research shows them to be ineffective. In fact several studies have come to the same conclusion, that essentially these injections are no better than a sham injection and do not give the patient any semblance of a long term result.
The problem however with any study is that the treatment is often applied to a more generalized group, lower back pain in this example. What needs to happen in order to give us better clinical indications is to break down the patients by diagnosis and treat only those who fit the criteria. that way the true success rate can be established.
In my own practice we are very meticulous in our selection process and patients are not accepted into any program unless we have been able to establish very specific clinical findings. That is why our success rate is so high, we only accept those we feel very strongly that we can help. Unlike many medical studies published apparently disproving individual treatments, where the study population is a mixed bag.
The truth is no one treatment has all the answers. In my experience the best treatment approach is one that addresses all of the various components of back and neck pain and treats them simultaneously, giving the patient the best possible chance of a successful outcome. That is what we strive for everyday at the Arizona Back Institute.
