Promotional feature
Low-back pain (LBP) is a common pain syndrome with a reported prevalence of over 70 per cent in industrialised countries [1]. Between 15 and 45 per cent of LBP can be attributed to lumbar facet joint origin [2]. First-line therapy often consists of a conservative, multi-modal approach (pharmacological management, non-steroidal anti-inflammatory drugs, physiotherapy), before progressing to diagnostic and/or therapeutic interventional procedures targeting the facet joint specifically. European Guidelines do not recommend the use of intra-articular (IA) corticosteroid (CS) facet joint injections for the management of non-specific chronic LBP [3]. Correspondingly, Cochrane Review guidelines for LBP injection therapy state there is insufficient evidence to support the use of IA CS for subacute (<6 weeks) and chronic (<12 weeks) conditions. However, they conclude that injection therapy should not be ruled out entirely, as subgroups of patients may respond positively to specific types of injection therapy [4].
Viscosupplementation (which utilises IA injections of Sodium Hyaluronate (SH)) has been proven to provide significant long-term therapeutic benefit for degenerative change within synovial joints, demonstrating significantly longer temporal reduction of pain and a greater degree of functional improvement when compared with CS injection [5]. Furthermore, no reports of serious or long-term adverse effects have been documented.