Table 13

Major and minor areas for future research

Minor areasMajor areas
Refine the means to identify target nerves (eg, real-time electromyography, more reliable stimulation technique).Develop safer and more efficient means for medial branch RFA (eg, laser therapy, high-intensity focused ultrasound).
Determine the best way to prevent major and minor complications (eg, nerve injury, neuritis).Identify ways to prolong benefit from RFA (eg, by injecting factors that inhibit nerve regeneration).
Identify non-ablative treatments for lumbar facet arthropathy (eg, tools to identify responders to IA steroids or to prolong benefit from steroids, pharmacotherapy, integrative treatments).Develop tools (eg, imaging, biomarkers, questionnaires) to identify painful facet joints.
Perform comparative-effectiveness studies to determine the optimal selection criteria and technique.Develop predictive modeling tools (ie, the use of history, examination findings, psychosocial metrics and imaging) to improve prognosis and better foretell outcomes.
Enhance precision of diagnostic blocks (eg, identify optimal injection volumes, number and types of blocks, amount of LA, needle location, needle size).Investigate role of regenerative therapies in reducing or reversing pain from arthritic facet joints.
  • IA, intra-articular; LA, local anesthetic; RFA, radiofrequency ablation