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Expert Consensus-Based Criteria for Identifying Lumbar Facet Joint Pain in Primary Care: Development Using Factor

Hiroaki Abe1,2, So Kato2,3, Hirokazu Takami2,4

  • 1Department of Pain and Palliative Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.

Pain and Therapy
|November 13, 2025
PubMed
Summary
This summary is machine-generated.

New diagnostic criteria for lumbar facet joint pain enable early detection by general practitioners. This noninvasive approach aids in timely referral and treatment for this common back pain cause.

Keywords:
Diagnostic criteriaFactor analysisLumbar facet joint painModified Delphi method

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Area of Science:

  • Orthopedics
  • Pain Medicine
  • Diagnostic Criteria Development

Background:

  • Lumbar facet joint pain is frequently misdiagnosed as nonspecific low back pain.
  • Current diagnostic methods like facet joint blocks are invasive and unsuitable for early screening.
  • Early identification is crucial for effective treatment of facet joint pain.

Purpose of the Study:

  • To develop practical, noninvasive diagnostic criteria for lumbar facet joint pain.
  • To create easily applicable criteria for general practitioners to facilitate early diagnosis.
  • To improve patient referral and treatment for facet joint pain.

Main Methods:

  • Systematic literature review of facet joint pain diagnostic items.
  • Expert survey of orthopedic spine surgeons to rate diagnostic item importance.
  • Factor analysis and Delphi rounds to establish consensus-based diagnostic criteria.

Main Results:

  • Extracted 77 diagnostic items from 8 articles; 25 were selected by 39 surgeons.
  • Factor analysis identified key diagnostic domains.
  • Four criteria established: physical findings, neurological symptoms, non-facet imaging, and discogenic pain signs.

Conclusions:

  • Developed consensus-based, noninvasive diagnostic criteria for lumbar facet joint pain.
  • The criteria provide a clinically practical tool for general practitioners.
  • Facilitates earlier recognition and appropriate management of facet joint pain.