Effectiveness of thermal radiofrequency ablation versus corticosteroid injections for pain reduction in facet-mediated chronic low back pain: a systematic review and meta-analysis
Year: 2026
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: Background Facet joint syndrome (FJS) is a prevalent cause of chronic low back pain (CLBP), resulting in reduced quality of life. Radiofrequency ablation (RFA) and corticosteroid injections are commonly utilized; however, direct comparative evidence specific to lumbar FJS remains limited.Methods A comprehensive search of PubMed, Embase, Web of Science, Cochrane Library, and Scopus (from inception to November 2025) was conducted to identify randomized controlled trials (RCTs) evaluating thermal RFA versus corticosteroid injections. The primary outcome measured was the Visual Analog Scale (VAS) at 3- and 6-months. Review Manager 5.4 was used to evaluate mean differences (MD) across outcomes using a random-effects model.Result Three RCTs with a total of 146 patients were included. Pooled analysis demonstrated significantly greater pain reduction with RFA at both 3-months (MD = −1.27; 95% CI, −1.96 to −0.58; p = 0.0003) and 6-months (MD = −0.86; 95% CI, −1.18 to −0.54; p < 0.00001), favoring RFA. Heterogeneity was moderate to low across timepoints. Although significant, these results fell underneath the minimally important clinical difference (MCID).Conclusion In our study, thermal RFA provided greater pain reduction than corticosteroid injections for FJS causing CLBP, suggesting a modest short-term advantage in pain reduction.
Source: Pain Management
Authors: Justin Le, Han Jie Liu, Andrew Atschinow, Lisa Huang, Jason Tran, Anish Rana, Brandon Lazar, Gilbert Siu
Language: English
Subfield: Anesthesiology and Pain Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7161538657