| Abstract | The work of a chronic back pain service in secondary care in the West Midlands is reported. The service offers acupuncture, spinal injection procedures, osteopathy and a range of other interventions for patients whose back pain has not responded to conservative management. This section of the report focuses on injection procedures for lumbar facet joint and sacroiliac joint pain, which have been shown to be the cause of chronic low back pain in 16-40% and 13-19% of patients respectively. Diagnosis relies on the use of intra-articular or sensory nerve block injections with local anaesthetic. Possible treatments following diagnosis include intra-articular corticosteroid, radiofrequency denervation (for facet joint pain) or ligament prolotherapy injections (for sacroiliac joint pain). The results of several hospital audits are reported. At six month follow up, 50% of 38 patients undergoing radiofrequency denervation following diagnostic blocks for facet joint pain had improved by more than 50%, compared to 29% of 34 patients treated with intra-articular corticosteroid injection. Sixty three per cent of 19 patients undergoing prolotherapy following diagnostic block injection for sacroiliac joint pain had improved at six months, compared to 33% of 33 who had intra-articular corticosteroid. Both radiofrequency denervation and sacroiliac prolotherapy showed good long-term outcomes at one year. |
| Authors | Robin Chakraverty, Richard Dias
(Affiliation: Royal Orthopaedic Hospital Birmingham. robin.chakraverty at roh.nhs.uk)
|
| Journal | Acupuncture in medicine : journal of the British Medical Acupuncture Society
(Acupunct Med)
Vol. 22
Issue 4
Pg. 207-13
(Dec 2004)
ISSN: 0964-5284 England |
| PMID | 15628778
(Publication Type: Journal Article)
|
| Chemical References |
- Adrenal Cortex Hormones
- Anti-Inflammatory Agents
|
| Topics |
- Acupuncture Therapy
(methods)
- Adrenal Cortex Hormones
(therapeutic use)
- Anti-Inflammatory Agents
(administration & dosage)
- Chronic Disease
- Follow-Up Studies
- Great Britain
- Humans
- Injections, Intra-Articular
- Injections, Spinal
- Low Back Pain
(prevention & control, rehabilitation, therapy)
- Lumbar Vertebrae
(innervation)
- Medical Audit
- Nerve Block
(methods)
- Pain Measurement
(methods)
- Patient Satisfaction
- Radio Waves
(therapeutic use)
- Sacroiliac Joint
(innervation)
- Treatment Outcome
|
