Category
Threshold Criteria
Non-radicular (non radiating) back pain is the commonest clinical presentation. Sometimes it is referred to as “mechanical back pain”. It is often the diagnosis for symptoms that are not caused by neural impingement or medically significant other causes.
The National Institute of Clinical Excellence (NICE) is clear in its guidance that intra-articular facet joint steroid injections should not be used in the treatment of pain originating from the lumbar facet joints.
The standards set by the Spinal Intervention Society and the joint standards of the British Pain Society and the Faculty of Pain Medicine state that
- Medial branch block as a diagnostic procedure leading to
- Radiofrequency denervation is the medial branch block is positive
Eligibility
| LLR ICB will fund medial branch blocks for the management of cervical, thoracic and lumbar back pain in the following clinical situations Diagnostic procedure leading to radiofrequency denervation of the medial branch if the diagnostic block is positive AND All conservative management options have been tried and failed – physiotherapy – exercise – pharmacotherapy including analgesia AND The pain has resulted in moderate to significant impact on daily life OR If the initial medial branch block has had a proven therapeutic benefit but the patient is not suitable for Radiofrequency Denervation or a Pain Management Programme (e.g. multiple comorbidities, cardiac and respiratory dysfunction, cardiac pacemaker or other nerve stimulator, or frail and elderly) |
Guidance
| ARP 42 Review Date: 2026 |
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