Interventional therapy for chronic low back pain

ABSTRACT

Chronic low back pain has become a major public health problem in Korea. The lifetime prevalence of low back pain has been reported to be as high as 90%. The prevalences of discogenic pain, facet joint pain, and sacroiliac joint pain are 42%, 30%, and 18%, respectively. Increasing age is associated with a decreasing probability of discogenic pain but increasing probabilities of facet joint pain and sacroiliac joint pain as the source of low back pain. Physical examination of low back pain is limited and imaging may lack objective clues. Diagnostic interventions allow us to determine the etiology of back pain. Techniques include lumbar disc stimulation, facet joint block, medial branch block, and sacroilliac joint block. Initial therapy includes modification of activity, pharmacological analgesic therapy, and education of patients. In patients with chronic low back pain, a multimodal and interdisciplinary treatment approach is necessary. Use of interventional treatments for chronic low back pain are increasing but their utilization remains uncertain or controversial. Therefore, management of patients with chronic and disabling low back pain remains a clinical challenge.