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

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.