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Pain and Spine Medicine

Radiofrequency Ablation Versus Corticosteroid Injections for Chronic Lumbar Back Pain Due to Facet Joint Syndrome: A Systematic Review and Meta-Analysis

Saturday, October 25, 2025
8:00 AM - 9:15 AM MT
Location: Kiosk 9
Has Audio

    Primary Author(s)

  • JL

    Justin Le, Other

    Medical Student
    Rowan-Virtua School of Osteopathic Medicine
    Blackwood, New Jersey

    • Co-Author(s)

  • AA

    Andrew Atschinow, Other

    Medical Student
    Rowan-Virtua School of Osteopathic Medicine
    Colts Neck, New Jersey

  • LH

    Lisa Huang, Other

    Student
    RowanSOM
    Stratford, New Jersey

  • JT

    Jason Tran, Other

    Medical Student
    Rowan-Virtua School of Osteopathic Medicine
    Magnolia, New Jersey

  • HL

    Han Jie Liu, Other

    Medical Student
    Rowan-Virtua SOM
    Blackwood, New Jersey

    • Poster Presenter(s)

  • Anish Rana, BA

    Medical Student
    University of Rochester School of Medicine and Dentistry
    Rochester, New York

    • Co-Author(s)

  • GS

    Gilbert Siu, DO, PhD

    Associate Professor
    Rowan University School of Osteopathic Med
    Mantua, New Jersey

Disclosure(s):
Justin Le, Other: No financial relationships to disclose
Anish Rana, BA: No financial relationships to disclose
Background and/or Objectives: Facet joint syndrome (FJS) is a common cause of chronic lumbar back pain (CLBP), with radiofrequency ablation (RFA) and corticosteroid injections as common treatments. Due to limited evidence comparing their effectiveness, our study aims to assess the efficacy of RFA versus corticosteroid injections for FJS causing CLBP.

Design: This review adhered to PRISMA 2020 guidelines. A boolean string was used to search PubMed, Embase, Web of Science, Cochrane Library, and Scopus.

Setting : Double and single-blinded randomized controlled trials across several institutions

Participants : Patients ≥ 18 years old diagnosed with FJS causing CLBP ≥ 3 months

Interventions: RFA versus corticosteroid injections of any approach or formulation

Main Outcome Measures: Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) at 3 and 6 months

Results: At 3 months, corticosteroid injections and RFA improved ODI scores compared to baseline (corticosteroids: d = -1.74, p < 0.001; RFA: d = -1.01, p = 0.01) with no significant difference in effectiveness (Q = 1.58, p = 0.21). At 6 months, corticosteroid injections showed borderline statistical significance (d = -4.29, p = 0.06), while RFA maintained effectiveness (d = -1.72, p = 0.008), with no difference in group effectiveness (Q = 1.13, p = 0.29). For VAS, both treatments were effective at 3 months (p < 0.001) and 6 months (p < 0.001), but corticosteroids had greater VAS score improvement compared to RFA at 6 months (Q = 4.77, p = 0.03). Despite high heterogeneity (I2 > 83%), both treatments improved pain and disability, with RFA showing better-sustained efficacy overall.

Conclusions: Our study supports the conclusion that both RFA and corticosteroid injections are effective treatments for CLBP. However, high heterogeneity across studies indicates differences in methodologies, patient populations, and intervention protocols. Therefore, future studies are needed to better understand the nuanced efficacy of RFA and corticosteroid injections for CLBP due to FJS.