Facet-related back pain – a common but hard-to-recognise cause
Back pain is among the most common complaints in our society. One often overlooked cause is facet-related back pain, which originates from the small vertebral joints known as facet joints. These joints can trigger pain as a result of wear and tear, overstrain, or instability – particularly in the cervical (neck) and lumbar (lower back) spine.
Why the diagnosis is so difficult
Imaging techniques such as X-rays or MRI often reveal degenerative changes, but these do not always correspond to the actual pain. To provide clarity, at ISSZ we use diagnostic injections: by selectively numbing the suspected joints or nerve branches, it is possible to determine whether the facet joints are the source of the pain.
Typical complaints
- Chronic pain in the neck or lumbar region
- Intensification of pain when getting up, overstretching, or twisting
- Morning stiffness
- Reduced mobility and muscular tension
These symptoms can significantly impair quality of life and highlight the importance of a targeted diagnostic evaluation.
Treatment at ISSZ
The therapy is tailored to the severity and the individual situation. Initially, conservative measures are usually recommended, such as physiotherapy, targeted exercises, ergonomic adjustments, and, if necessary, medication.
If the pain is not sufficiently relieved, further options are available:
Injections (intra-articular or medial branch block) can provide short-term pain reduction while also contributing to diagnostic confirmation.
Radiofrequency ablation (RFA) has proven to be particularly effective. In this procedure, pain-transmitting nerve fibres are specifically cauterised. Many patients report a significant improvement that can last for up to twelve months.
Future prospects
New regenerative approaches such as PRP (platelet-rich plasma) are currently being investigated scientifically. They show promising potential, but the evidence is not yet sufficient for them to be recommended as standard therapy.
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Thermal radiofrequency denervation (RFD) is an established, minimally invasive procedure for the treatment of chronic low back pain when it originates from the facet joints.
Low-Dose Naltrexone (LDN)
Low-Dose Naltrexone (LDN) is a well-tolerated medication used to relieve chronic pain, particularly in cases of fibromyalgia and immune dysregulation. In addition to pain relief,
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Through targeted ablation, commonly referred to as “nerve cauterization,” pain signal transmission from a specific body region to the central nervous system (brain and spinal
Modern imaging in pain medicine cloud based with PACSonWEB
In interventional pain medicine reliable access to imaging procedures such as ultrasound or BV X ray devices is essential. From the very beginning we decided
Lecture activity in the field of pain medicine
Lecture activity in the field of pain medicine The continuous sharing of specialist knowledge and the exchange with colleagues from various medical disciplines are a
Dr Marios Moniatis strengthens the ISSZ team
We are delighted to welcome Dr Marios Moniatis to our team Dr Marios Moniatis is a board-certified specialist in anaesthesiology (FMH) and a certified expert