title: Prevalence and clinical features of lumbar zygapophysial joint pain: a study in an Australian population with chronic low back pain.
abstract: OBJECTIVE
  To determine the prevalence of pain arising from the zygapophysial joint in patients with chronic low back pain and to determine whether any clinical features could distinguish patients with and without such pain.
  
  
  METHODS
  Sixty three patients with chronic low back pain were studied prospectively. All patients underwent a detailed history and physical examination as well as a series of intra-articular zygapophysial joint injections of 0.5% bupivacaine starting at the symptomatic level to a maximum of three levels or until the pain was abolished. They also received injections of normal saline into paraspinal muscles to act as controls.
  
  
  RESULTS
  All patients proceeded with the injections. Twenty (32%; 95% confidence interval (CI) 20 to 44%) obtained greater than 50% relief of their pain following the administration of saline. Fifty seven patients completed the study; 23 of them (40%; 95% CI 27 to 53%) failed to obtain relief following the injection of saline but obtained relief following one or more intra-articular injections of local anaesthetic. None of the historical features or clinical tests could discriminate those patients with and those without zygapophysial joint pain.
  
  
  CONCLUSIONS
  Pain originating from the zygapophysial joint is not uncommon, but this study failed to find any clinical predictors in patients with such pain.
authors.affiliation: Faculty of Medicine, University of Newcastle, Callaghan, NSW, Australia.
authors.forename: A C
authors.initials: AC
authors.lastname: Schwarzer
authors.forename: S C
authors.initials: SC
authors.lastname: Wang
authors.forename: N
authors.initials: N
authors.lastname: Bogduk
authors.forename: P J
authors.initials: PJ
authors.lastname: McNaught
authors.forename: R
authors.initials: R
authors.lastname: Laurent
mesh_terms: D000368:Aged; D001315:Australia / Q000453:epidemiology; D002045:Bupivacaine / Q000008:administration & dosage; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D017116:Low Back Pain / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D013122:Spinal Diseases / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology
chemical_list: D002045:Bupivacaine