347: Effects of Facet Nerve Blocks on Pain, HRQoL, Disability, and Cost-Effectiveness Across Age Groups

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic primary musculoskeletal pain, Non-pharmacological treatments, Pain in Special Populations , Treatment/management

Background and Aims: Low back pain is a common symptom, estimated to affect up to 80% of individuals at some point in their lives, and causing significant disability.
Needle-based interventions are commonly used for low-back pain treatment and interventions of the facet (zygapophyseal) joints are the second most common procedure in interventional pain medicine. The present study examined effects of Facet-Nerve Blocks on back pain in different age groups
We also studied changes in the Quality of Life (EQ5D), functioning (Oswestry disability index) and treatment costs in means of QALY

Methods: The study population consisted of 1820 consecutive subjects with chronic back pain who underwent diagnostic / therapeutic facet- nerve block at the unit for Physical Medicine and Rehabilitation in Finland between 2019-2022. Mean age for patients was 64 years and 65% were women.

Results: Mean back pain scores declined from 6.7 before treatment to 2.5 immediately after the procedure, 3.1 at 2 hours, 3.5 at 2 days, and 4.4 at 1 month post-intervention. No statistically significant differences were observed between age groups. Patients aged 30–41 years reported lower baseline pain and smaller absolute pain reductions compared with older age groups.
Significant improvements in health-related quality of life were observed across all age groups. The mean EQ-5D index increased from 0.378 at baseline to 0.521 after FNB (P < 0.0001).

Functional disability, (ODI), also improved, decreasing from 40.0% at baseline to 32.8% at 1-month follow-up.

Conclusions: The data demonstrate a consistent and clinically meaningful reduction in back pain following FNB and nerve root block procedures across all age groups, although younger patients tended to report lower baseline pain and smaller absolute improvements
Sensitivity analysis showed that the treatment was cost-effective in all scenarios evaluated, using the patients as their own controls. From a societal perspective, the total treatment cost was €910,000, and the total quality-adjusted life years (QALYs) gained were 244.8. The cost per QALY gained was €3,978 when one treatment was required and €11,934 when three treatments were required, indicating favorable cost-effectiveness.

References: Cohen SP, Williams KA, Kurihara C, Nguyen C, Shields C, Kim P, Griffith SR, Larkin TM, Crooks M, Williams N, Morlando B, Strassels SA: Multicenter, randomized, comparative costeffectiveness study comparing 0, 1, and 2 diagnostic medial branch (facet joint nerve) block treatment paradigms before lumbar facet radiofrequency denervation. Anesthesiology 2010; 113:395–405.
Hyung-Sun Won, Miyoung Yang, Yeon-Dong Kim. Facet joint injections for management of low back pain: a clinically focused review. Anesth Pain Med (Seoul). 2020 Jan 31;15(1):8–1
Hambraeus J, Pulkki-Brännström A-M, Lindholm L.Cost-effectiveness of Radiofrequency
Denervation for Zygapophyseal Joint Pain. Pain Physician 2021; 24:E1205-E1218

Presenting Author: hannu heikkilä
Submitting Author: hannu heikkilä

Senior Author: hannu heikkilä

IASP 2026 Global Year theme of Neuropathic Pain: No

• hannu heikkilä: MD PhD - UEF.fi