Date of Award


Document Type

Independent Study

Degree Name

Master of Science (MS)


Clinic spinal pain or "back pain" as it is sometimes referred is a serious medical problem with se1ious financial and social consequences (Manchikanti, 1999). Back and neck pain are the most common cause of chronic pain and disability (Raso, 2010). Certified Registered Nurse Anesthetists are advanced practitioners with the ability to treat lower back pain using advanced interventional procedures; however, they currently are not pardoning these interventions in North Dakota. A comprehensive literature review was utilized to gather current data and group trends in the treatment of lumbar facet joint pain. History and physicals, while helpful, do not accurately diagnose lumbar facet joint pain. Advanced imaging using x-ray, CT, and MRI also does not correctly diagnose lumbar facet joint mediated back pain. Repeated, controlled diagnostic nerve blocks are the only proven method of diagnosing lumbar back pain of facet origin. Four treatment modalities: intra-articular injection, lumbar pen-articular injection, medial branch block, and medial branch neurotomy are described in this paper. Controlled diagnostic blocks are the best means to diagnose facet mediated lower back pain. Medial branch block and neurotomy provide the highest percentage forelife for the greatest period of time out of the interventions explored. Presentation of these findings to Certified Registered Nurse Anesthetists and Student Registered Nurse Anesthetists will increase their knowledge base and raise awareness of diagnostic and treatment options for lumbar facet joint pain.