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      Chronic unilateral low-back pain. Predictors of outcome of facet joint injections.

      Spine

      administration & dosage, Adult, Anesthetics, Local, therapeutic use, Back Pain, drug therapy, Cortisone, Female, Humans, Injections, Intra-Articular, Male, Middle Aged, Regression Analysis, Sodium Chloride

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          Abstract

          One hundred nine patients with chronic (3-36 months; mean, 13.4 months) unilateral low-back pain and no signs of sciatica were subjected to facet joint injection, randomized in three therapy groups: cortisone and local anesthetic injected intra-articularly, the same mixture injected pericapsularly, and physiologic sodium hydrochloride injected intra-articularly into two facet joints. To evaluate the results, three outcome variables were formed: work, subjective, and disability outcome. The inappropriate signs (IAS) recorded before injections had the best predictability for a good outcome. The mode of injection or duration of symptoms had no significance as a predictor. It was concluded that the outcome after facet joint injection depends on the patient's biopsychosocial chances of self-facilitated improvement. If abnormal illness behavior and distress are found, it helps to estimate the response for treatment and to choose a realistic method of treatment.

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          2146756

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