| Methods |
RCT; Random number system, concealment of assigned technique from referring clinicians and patients. |
| Participants |
Pain or back clinic, Dundee, Scotland.
86 patients with lumbar or lumbosacral pain present most of the time for at least 6 months. Exclusion criteria were a radicular pattern in either lower limb, straight leg raising limited at less than 60 degrees and no evidence of any progressive spinal disorder of non‐degenerative origin. |
| Interventions |
(1) Facet joint injection with 0.5 ml DepoMedrol (20 mg methylprednisolone acetate) followed by 1.5 ml lignocaine. (1%) at the lumbosacral level and at every other level 0.5 ml DepoMedrol followed by 1.0 ml lignocaine.
(2) Facet nerve block of the medial articular branch of the posterior primary ramus from L1 to L5. |
| Outcomes |
Timing of outcomes: before and 30‐60 minutes, 1 month and 3 months after infiltration.
The facet joints injections did slightly better in relieving pain than the facet nerve blocks. This difference reached statistical significance only at 1 month but not immediately after infiltration, at 2 weeks and at 3 months. |
| Notes |
Side effects: no serious complications. Transient symptoms, such as headache, paresthesia of one leg, nausea and worsening of pain occurred 15 times in the injection group and 18 times in the nerve block group. |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Adequate sequence generation? |
Low risk |
Random number system |
| Allocation concealment? |
Low risk |
A ‐ Adequate ‐ concealment of assigned technique from referring clinicians and patients |
| Blinding?
All outcomes ‐ patients? |
Low risk |
|
| Blinding?
All outcomes ‐ care providers? |
Unclear risk |
unclear from text |
| Blinding?
All outcomes ‐ outcome assessors |
Low risk |
|
| Incomplete outcome data addressed?
All outcomes ‐ drop‐outs? |
Low risk |
|
| Incomplete outcome data addressed?
All outcomes ‐ ITT analysis |
High risk |
|
| Similarity of baseline characteristics? |
Low risk |
|
| Co‐interventions avoided or similar? |
High risk |
|
| Compliance acceptable? |
Low risk |
|
| Timing outcome assessments similar? |
Low risk |
|
