Chronic unilateral low-back pain. Predictors of outcome of facet joint injections.
One hundred nine patients with chronic (3-36 months; mean, 13.4 months) unilateral low-back pain and no signs of sciatica were subjected to facet joint injection, randomized in three therapy groups: cortisone and local anesthetic injected intra-articularly, the same mixture injected pericapsularly, and physiologic sodium hydrochloride injected intra-articularly into two facet joints. To evaluate the results, three outcome variables were formed: work, subjective, and disability outcome. The inappropriate signs (IAS) recorded before injections had the best predictability for a good outcome. The mode of injection or duration of symptoms had no significance as a predictor. It was concluded that the outcome after facet joint injection depends on the patient's biopsychosocial chances of self-facilitated improvement. If abnormal illness behavior and distress are found, it helps to estimate the response for treatment and to choose a realistic method of treatment.
Lilius
G
G
Department of Physical Medicine and Rehabilitation, Helsinki University Central Hospital, Finland.
Harilainen
A
A
Laasonen
E M
EM
Myllynen
P
P
D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D001416:Back Pain / Q000188:drug therapy*; D003348:Cortisone / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012965:Sodium Chloride / Q000008:administration & dosage
D000779:Anesthetics, Local; D012965:Sodium Chloride; D003348:Cortisone