Lumbar facet joint steroid injection versus Radiofrequency denervation for chronic low back pain: systematic review

Study aim: The study aimed to compare the clinical efficacy and safety of radiofrequency denervation versus corticosteroid injection for chronic low back pain originating from the lumbar facet joints. Methods: According to PRISMA 2020 guidelines we searched PubMed, Web of Science, Scopus, CENTRAL, and Embase from inception to 2025. Eligible studies included adults with chronic lumbar facet mediated pain treated with RFD or corticosteroid-based facet interventions. Pain reduction was the primary outcome; disability, treatment success, and adverse events were secondary outcomes. Results: We include 16 primary studies involving more than 1,900 participants, with follow-up from 3 to 24 months. Both interventions reduced pain, and corticosteroid injections produced faster short-term relief, whereas radiofrequency techniques showed more durable pain control and better long-term functional improvement in several comparative studies. Sham-controlled trials and the MINT trials did not show clinically important advance of routine radiofrequency over control strategies, which indicate that patient selection, diagnostic rigor, and procedural technique impact outcomes. Both treatments were safe, with minor adverse events reported. Conclusion: Facet steroid injection is useful for early symptom control, whereas RFD provide longer-lasting benefit in carefully selected patients with confirmed facetogenic pain.