University of Hertfordshire

  • M. C. Cairns
  • Tom Mars
  • Kirsty Haywood
  • Claudia Lega
  • Harbinder Sandhu
  • David Ellard
  • Susie Keohane
  • Martin Underwood
View graph of relations
Original languageEnglish
Publication statusPublished - 2014
Event13th International Forum on Low Back Pain Research in Primary Care - Campos do Jordão, Brazil
Duration: 30 Sep 20143 Oct 2014


Conference13th International Forum on Low Back Pain Research in Primary Care
CityCampos do Jordão


Between 5-15% of people with chronic LBP are believed to have disease of one or more facet joints contributing to their pain yet there is considerable uncertainty on how to identify and treat such people.
This pilot RCT will test the hypothesis that, for people with suspected facet joint pain contributing to persistent LBP, adding facet joint injections, with local anaesthetic and corticosteroids, to best usual non-invasive care available from the NHS is both clinically and cost effective.
Patients referred to secondary care with persistent non-specific LBP will be screened. Those meeting the eligibility criteria will receive a 1 hour assessment with a physiotherapist to confirm diagnosis and collect baseline data. All participants (n=150) will be offered a bespoke package of physical and behavioral rehabilitation. Those randomized into the intervention arm (n=75) will, in addition, receive facet joint injections. Primary outcome data will be collected using daily and then weekly text messaging service for a pain score on a 0-10 scale. Questionnaire follow up will be at 3, 6, and 12 months.
Results:To inform the ’diagnosis’ and ‘best usual care’ package two systematic reviews have been undertaken
1. non-invasive ‘diagnosis’ of suspected facet joint pain
2. the physical therapy management of patients with ‘facet joint pain’ including psychological or cognitive behavioral approaches delivered by non-psychologists. MEDLINE, EMBASE, CINAHL, AMED and BIOSIS have been searched alongside the grey literature, hand searching and narrative evidence synthesis from seminal texts of physical therapy.
Recruitment will start in four sites in November 2014.

ID: 9167841