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Facet joint osteoarthritis as a component of non-specific low back pain

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Back pain is a significant sociomedical problem due to its high prevalence and negative impact on quality of life. According to the latest data, the pain persists in a considerable number of patients for a year or even several years after its onset, which necessitates the search for a cause of the pain syndrome. The facet syndrome induces pain in 15–66% of cases and is most often due to facet joint osteoarthritis. A comprehensive clinical and diagnostic examination helps one to identify facet joint injury; and targeted pathogenetic and multimodal therapy, including non-steroidal anti-inflammatory drugs, provides complete pain relief in most cases and slows the progression of the disease.

About the Author

O. S. Davydov
Research Institute of General Pathology and Pathophysiology
Russian Federation
8, Baltiyskaya St., Moscow 125315


1. Hoy D, Bain C, Williams G, et al. A systematic review of the global prevalence of low back pain. Arthritis Rheum. 2012;64(6):2028-37. doi: 10.1002/art.34347

2. Balague F, Mannion AF, Pellise F, Cedraschi C. Non-specific low back pain. Lancet. 2012; 379:482-91. doi: 10.1016/S0140-6736(11)60610-7

3. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015 Jun 7. pii: S0140-6736(15)60692-4

4. Matrosov DN, Galushko EA, Erdes ShF. Epidemiology of lower back pain in outpatient practice. Bol'. 2009;4(25):23-8 (In Russ.).

5. Yakhno NN, Kukushkin ML, Churyukanov MV, Syrovegin AV. The results of the open multicenter study «MERIDIAN» to assess the prevalence of pain syndromes in outpatient practice and therapeutic preferences of doctors. Rossiiskii Zhurnal Boli. 2012;3(36-37):10-4 (In Russ.).

6. Knaggs R. Low back pain clinical guidelines: similarities and divergent views across the pond. Br J Pain. 2017 May;11(2):70. doi: 10.1177/2049463717701809

7. Mehling WE, Gopisetty V, Bartmess E, et al. The prognosis of acute low back pain in primary care in the United States: a 2-year prospective cohort study. Spine (Phila Pa 1976). 2012 Apr 15;37(8):678-84. doi: 10.1097/BRS.0b013e318230ab20

8. Itz CJ, Geurts JW, van Kleef M, Nelemans P. Clinical course of non-specific low back pain: a systematic review of prospective cohort studies set in primary care. Eur J Pain. 2013 Jan;17(1): 5-15. doi: 10.1002/j.1532-2149.2012.00170.x

9. Freburger JK, Holmes GM, Agans RP, et al. The rising prevalence of chronic low back pain. Arch Intern Med. 2009 Feb 9;169(3):251-8. doi: 10.1001/archinternmed.2008.543

10. Manchikanti L, Pampati VS, Fellows B, et al. Prevalence of lumbar facet joint pain in chronic low back pain. Pain Physician. 1999;2:59-64.

11. Schwarzer AC, Wang S, Bogduk N, et al. Prevalence and clinical features of lumbar zygapophysial joint pain: A study in an Australian population with chronic low back pain. Am Rheum Dis. 1995;54:100-6. doi: 10.1136/ard.54.2.100

12. Bogduk N. Lumbar Facet Syndrome. In: Steven D. Waldman SD, ed. Pain Management. Philadelphia: W.B. Saunders; 2007. P. 769-76.

13. Varlotta GP, Lefkowitz TR, Schweitzer M, et al. The lumbar facet joint: a review of current knowledge: part 1: anatomy, biomechanics, and grading. Skeletal Radiol. 2011;40(1):13-23. doi: 10.1007/s00256-010-0983-4

14. Igarashi A, Kikuchi S, Konno S, Olmarker K. Inflammatory cytokines released from the facet joint tissue in degenerative lumbar spinal disorders. Spine (Phila Pa 1976). 2004 Oct 1;29(19):2091-5. doi: 10.1097/01.brs.0000141265.55411.30

15. Genevay S, Finckh A, Payer M, et al. Elevated levels of tumor necrosis factor-alpha in periradicular fat tissue in patients with radiculopathy from herniated disc. Spine (Phila Pa 1976). 2008 Sep 1;33(19):2041-6. doi: 10.1097/BRS.0b013e318183bb86

16. Gellhorn AC, Katz JN, Suri P. Osteoarthritis of the spine: the facet joints. Nat Rev Rheumatol. 2013 Apr;9(4):216-24. doi: 10.1038/nrrheum.2012.199

17. Vorob'eva OV. Facet syndrome as a cause of back pain. Effektivnaya Farmakoterapiya. 2012;(1):4-9 (In Russ.).

18. Davydov OS, Pavlova LV, Zhukov EV. Facet Syndrome. Vrach. 2015;(10):8-14 (In Russ.).

19. Van Kleef M, Vanelderen P, Cohen SP, et al. Pain originating from the lumbar facet joints. Pain Pract. 2010;10:459-69. doi: 10.1111/j.1533-2500.2010.00393.x

20. Dwyer A, Aprill C, Bogduk N. Cervical zygapophyseal joint pain patterns. I: A study in normal volunteers. Spine (Phila Pa 1976). 1990 Jun;15(6):453-7. doi: 10.1097/00007632-199006000-00004

21. Parfenov VA, Isaikin AI. Boli v poyasnichnoi oblasti [Pain in the lumbar region]. Moscow; 2018. 200 p. (In Russ.).

22. Diez-Ulloa MA, Almira Suarez EL, Otero Fernandez M, et al. Lordosis manoeuvre in the diagnosis of lumbar facet syndrome. Rev Esp Cir Ortop Traumatol. 2016 Jul-Aug;60(4):221-6.

23. Gomez Vega JC, Acevedo-Gonzalez JC. Clinical diagnosis scale for pain lumbar of facet origin: systematic review of literature and pilot study. Neurocirugia (Astur). 2018 Jun 14. pii: S1130-1473(18)30051-4

24. Kalichman L, Li L, Kim D, et al. Facet joint osteoarthritis and low back pain in the community-based population. Spine (Phila Pa 1976). 2008;33:2560-5. doi: 10.1097/BRS.0b013e318184ef95

25. Saal JS. General principles of diagnostic testing as related to painful lumbar spine disorders: a critical appraisal of current diagnostic techniques. Spine (Phila. Pa. 1976). 2002;27(22):2538-45. doi: 10.1097/00007632-200211150-00027

26. Chou R, Hashimoto R, Friedly J, et al. Pain Management Injection Therapies for Low Back Pain [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2015 Mar. AHRQ Technology Assessments.

27. Qaseem А, Wilt TJ, McLean RM, et al. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166(7):514-30. doi: 10.7326/M16-2367

28. Parfenov VA, Yakhno NN, Kukushkin ML, et al. Acute nonspecific (musculoskeletal) low back pain. Guidelines of the Russian Society for the Study of Pain (RSSP). Nevrologiya, Neiropsikhiatriya, Psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2018;10(2):4-11 (In Russ.). doi: 10.14412/2074-2711-2018-2-4-11

29. Nasonov EL, Yakhno NN, Karateev AE, et al. General principles of treatment for musculoskeletal pain: Interdisciplinary consensus. Nauchno-Prakticheskaya Revmatologiya = Rheumatology Science and Practice. 2016;54(3):247-265 (In Russ.). doi: 10.14412/1995-4484-2016-247-265

30. Roelofs PD, Deyo RA, Koes BW, et al. Nonsteroidal anti-inflammatory drugs for low back pain: an updated Cochrane review. Spine (Phila Pa 1976). 2008;33:1766-74. doi: 10.1097/BRS.0b013e31817e69d3

31. De Vecchis R, Baldi C, Di Biase G, et al. Cardiovascular risk associated with celecoxib or etoricoxib: a meta-analysis of randomized controlled trials which adopted comparison with placebo or naproxen. Minerva Cardioangiol. 2014 Dec;62(6):437-48.

32. Ramey D, Watson D, Yu C, et al. The incidence of upper gastrointestinal adverse events in clinical trials of etoricoxib vs. non-selective NSAIDs: an updated combined analysis. Curr Med Res Opin. 2005;21(5):715-22. doi: 10.1185/030079905X43686

33. Malmstrom K, Sapre A, Couglin H, et al. Etoricoxib in acute pain associated with dental surgery: a randomized, double-blind, placeboand active comparator-controlled dose-ranging study. Clin Ther. 2004 May;26(5):667-79. doi: 10.1016/S0149-2918(04)90067-7

34. Moore R, Moore O, Derry S, et al. Responder analysis for pain relief and numbers needed to treat in a meta-analysis of etoricoxib osteoarthritis trials: bridging a gap between clinical trials and clinical practice. Ann Rheum Dis. 2010;69:374-9. doi: 10.1136/ard.2009.107805

35. Jung SY, Jang EJ, Nam SW, et al. Comparative Effectiveness of Oral Pharmacologic Interventions for Knee Osteoarthritis: A Network Meta-analysis, 2018. Modern Rheumatol. 2018;28(6). doi: 10.1080/14397595.2018.1439694

36. Arendt-Nielsen L, Egsgaard LL, Petersen KK. Evidence for a central mode of action for etoricoxib (COX-2 inhibitor) in patients with painful knee osteoarthritis. Pain. 2016 Aug;157(8):1634-44. doi: 10.1097/j.pain.0000000000000562

37. Moss P, Benson HAE, Will R, Wright A. Fourteen days of etoricoxib 60 mg improves pain, hyperalgesia and physical function in individuals with knee osteoarthritis: a randomized controlled trial. Osteoarthritis Cartilage. 2017 Nov;25(11):1781-91. doi: 10.1016/j.joca.2017.07.009

38. Sharma L. Osteoarthritis year in review 2015: clinical. Osteoarthritis Cartilage. 2016 Jan;24(1):36-48. doi: 10.1016/j.joca.2015.07.026

39. Cohen SP, Huang JH, Brummett C. Facet joint pain – advances in patient selection and treatment. Nat Rev Rheumatol. 2013;9(2):101- 16. doi: 10.1038/nrrheum.2012.198

40. Manchikanti L, Helm S, Singh V. An algorithmic approach for clinical management of chronic spinal pain. Pain Physician. 2009;12(4): 225-64.


For citations:

Davydov O.S. Facet joint osteoarthritis as a component of non-specific low back pain. Neurology, Neuropsychiatry, Psychosomatics. 2019;11(2S):76-82. (In Russ.)

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ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)