Facet Disease: An under-appreciated Cause of Lower Back Pain

Common procedures

• Nerve Root block (radiculitis)
• Transforaminal epidural
• Inter laminar epidural
• Facet and or medial branch block (facets)
• RFA for facet arthropathy

Facet Arthropathy

• Common source of pain
  • 15-40% of back pain
  • Symptoms often simulate disc related pathology
  • Follows disc degeneration
• 3 mechanisms of pain
  • Synovial joint arthritis
  • Impingement on adjacent nerves
  • Referred pain…may simulate radiculopathy