Is There Correlation of Facet Joint Pain in Lumbar and Cervical Spine? An Evaluation of Prevalence in Combined Chronic Low Back and Neck Pain

Abstract

Among the chronic pain problems, pain emanating from cervical and lumbar regions, independently or in combination, constitutes a significant and frequently encountered problem in interventional pain management practices. This study was designed to test the assumption that patients presenting with chronic low back pain of lumbar facet joint origin may also present with chronic neck pain of facet joint origin. Considering that many studies show the prevalence of facet joint involvement in chronic low back pain as ranging from 15% to 45% compared to prevalence of involvement of cervical facets in chronic neck pain, ranging from 54% to 60%, we sought to evaluate the correlation between lumbar facet joint to cervical facet joint pain. One hundred twenty consecutive patients with chronic neck and low back pain were evaluated utilizing controlled diagnostic blocks with lidocaine and bupivacaine. The results showed prevalence of cervical facet joint pain in 67% of the patients with a false-positive rate of 63% with a single block, whereas the prevalence of lumbar facet joint pain was seen in 40% of the patients with a 30% false-positive rate with a single block in patients presenting with chronic low back and neck pain. There was also significant correlation noted with 94% of the patients with confirmed lumbar facet joint pain also presenting with cervical facet joint pain.