Facet-joint injections for people with persistent non-specific low back pain (FIS)

The Facet Injection Study (FIS) is a mixed-methods, randomised, multicentre feasibility study to assess the clinical and cost-effectiveness of facet joint injections compared to best usual non-invasive care in patients with persistent non-specific low back pain.

Facet joint injections into the back have been widely used to treat selected people with low back pain. A facet joint injection is not a cure for the cause of low back pain, but it is used to help reduce the level of pain. For the NHS to provide these injections, we need evidence to show that they work. Unfortunately there is currently no good evidence to show this.

Adult patients with at least moderately troublesome low back pain, present for at least six months, referred by their GP for additional treatment of back pain because simple treatments for low back pain have not worked.

Upon confirmation of eligibility criteria, patients will be randomised to receive either facet joint injections and 'best usual care' physiotherapy treatment, or 'best usual care' physiotherapy treatment only. Patients will be followed-up via postal questionnaires. The main questionnaire packages are completed at baseline (at study entry assessment) and follow-up (3, 6, and 12 months post-randomisation). A pain severity score will be recorded daily for 35 days from seven days before the first treatment session and, following this, will continue to be recorded weekly until the end of the study.

Patient recruitment will start in November 2014 and end April 2015. Patient follow-up will be complete in November 2015.