Treatment of Facet Joints

Lumbar zygapophysial joints are also called “facet joints”. They are often cause of chronic back pain because of rich innervation of the articular structures. In 1933, Ghormley named the spectrum of symptoms arising from its pathological involvement as “facet joint syndrome” (FCS). FCS represents ≤15% of chronic pain in the lower back. It is characterized by joint pain which is usually insidious in its onset and which may derive from almost any structure in the zygapophysial joints (fibrous capsule, synovial membrane, hyaline cartilage, tendons, bone) due to mechanical or inflammatory stimulation of nociceptors. Standard treatments for pain in lumbar facet joints are mainly intra-articular injections of corticosteroids and radiofrequency denervation (RFD) of the medial branches which innervate the zygapophysial joint. We review here the anatomy and physiology of the lumbar zygapophysial joints as well as diagnostic tools and treatments.