Physiotherapy and lumbar facet joint injections as a combination treatment for chronic low back pain. A narrative review of lumbar facet joint injections, lumbar spinal mobilizations, soft tissue massage and lower back mobility exercises.
Study Goal
The researchers aimed to evaluate the effectiveness of soft tissue massage, among other physiotherapy treatments, for chronic low back pain (CLBP) and its potential combination with lumbar facet joint injections.
Results Summary
Soft tissue massage showed a positive short-term effect on CLBP, with possible longer-term benefits, though the evidence for lumbar spinal mobilizations was insufficient to draw conclusions.
Population
Patients with chronic low back pain (CLBP).
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
lumbar facet joint injections | decrease | chronic low back pain (CLBP) | - | short-term | suggests an overall short-term positive effect | #1 |
land-based lower back mobility exercise | decrease | chronic low back pain (CLBP) | - | short term and possibly in the longer term | appear to have a positive effect | #2 |
soft tissue massage | decrease | chronic low back pain (CLBP) | - | short term and possibly in the longer term | appear to have a positive effect | #3 |
lumbar spinal mobilizations | no change | - | - | - | insufficient evidence to draw conclusions | #4 |
lumbar facet joint injections | decrease | pain | - | short period | create a short period when pain is reduced | #5 |
physiotherapy treatments including land-based lower back mobility exercise and soft tissue massage | increase | longer-term outcomes | patients with CLBP | - | may be of benefit during this time to improve the longer-term outcomes | #6 |
OBJECTIVES: The aim of this study was to summarize the available evidence on lumbar facet joint injections and the physiotherapy treatments, land-based lower back mobility exercise, soft tissue massage and lumbar spinal mobilizations for chronic low back pain (CLBP). The plausibility of physiotherapy and lumbar facet joint injections as a combination treatment is discussed. METHODS: Using a systematic process, an online electronic search was performed using key words utilizing all available databases and hand searching reference lists. Using a critical appraisal tool from the Critical Appraisal Skills Programme (CASP), the literature was screened to include primary research. The main aspects of the research were summarized. RESULTS: The evidence for lumbar facet joint injections suggests an overall short-term positive effect on CLBP. Land-based lower back mobility exercise and soft tissue massage appear to have a positive effect on CLBP in the short term and possibly in the longer term. There is insufficient evidence to draw conclusions for lumbar spinal mobilizations. CONCLUSION: The review indicates that lumbar facet joint injections create a short period when pain is reduced. Physiotherapy treatments including land-based lower back mobility exercise and soft tissue massage may be of benefit during this time to improve the longer-term outcomes of patients with CLBP. It is not possible to make generalizations or firm conclusions. The current review highlights the need for further research. A randomized controlled trial is recommended to assess the impact of physiotherapy in combination with lumbar facet joint injections on CLBP.