Comparing ultrasound-guided intra-articular injection and medial branch block for lumbar facet joint pain: a clinical study

PURPOSE This study aims to compare the effectiveness of ultrasound-guided intra-articular (IA) injections with medial branch nerve blocks in treating lumbar facet joint pain. METHODS This retrospective study enrolled 94 patients clinically diagnosed with lumbar facet joint pain. Diagnostic blocks confirmed the diagnosis in 82 patients, evidenced by a pain visual analog score (VAS) reduction of at least 50% immediately following the injection. Of these, 42 were treated with ultrasound-guided IA injections (group 1), and 40 received ultrasound-guided medial branch blocks (group 2). Effective pain relief was defined as a VAS reduction of at least 50%. RESULTS Group 1 showed significantly higher pain relief rates compared with group 2 at both 1-month (54.76% versus 2.5%, P < 0.001) and 3-month (26.19% versus 5%, P = 0.014) follow-ups. Within group 1, patients aged 21-50 years experienced higher relief rates (81.25% at 1-month and 56.25% at 3-month follow-ups) compared with those over 50 (38.46% at 1-month and 7.69% at 3-month follow-ups), which was statistically significant (P = 0.007 at 1-month and P = 0.001 at 3-month follow-ups). Furthermore, in group 1, patients with sedentary jobs reported significantly greater pain relief (90.91% at 1-month and 81.82% at 3-month follow-ups) compared with those with non-sedentary jobs (41.94% at 1-month and 6.45% at 3-month follow-ups) (P = 0.005 at 1-month and P < 0.001 at 3-month follow-ups). CONCLUSION Ultrasound-guided IA injection provides better pain relief compared with medial branch nerve blocks. This method serves as a viable alternative for patients, especially younger and middle-aged patients with lumbar facet pain due to sedentary lifestyles.