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Low Back Pain – Causes

February 11, 2021


"So one of the most common causes of low back pain is arthritis of the facet joint. The facet joint is also called the zygapophysial joint or Z joint. So this joint is a synovial joint, meaning it has a capsule, synovial fluid in it, and cartilage. These pairs of joints run all the way up from your cervical spine down to your lower back. And these joints, just like your fingers, your knees, your hip joints, can develop osteoarthritis, which is demonstrable on imaging studies. While many people can have arthritis without pain, some people develop very painful neck or low back pain related to these joints. So treatment for pain from these joints requires really comprehensive treatment, including exercise, weight reduction and cognitive strategies to improve the mind's relationship with the pain. There's a procedure that spine specialists perform to alleviate pain from these joints. And it's called radiofrequency lesioning, also commonly called rhizotomy or radio frequency ablation. So the idea behind it is that the facet joints, these arthritic joints are actually innervated by small nerves that run right alongside the joint. So using x-ray image guidance called a fluoroscope, small needles are inserted against the nerves and an anesthetic is injected. Now, if the pain improves substantially, when the anesthetic is injected, this supports the notion that the pain is emanating from that facet joint. And thus, this facet denervation procedure would make sense to pursue. So this procedure can be done with only local anesthetic and is performed on an outpatient basis. And patients are usually able to resume their normal activities the very next day."

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