I was always bemused by “specialists” that point out facet OA changes and claim to patients these old age changes are responsible for their pains. Now the Framingham study has put a nail in the coffin for that attitude.
Spine. 2008 Oct 14. [Epub ahead of print] Facet Joint Osteoarthritis and Low Back Pain in the Community-Based Population. Kalichman L, Li L, Kim DH, Guermazi A, Berkin V, O’Donnell CJ, Hoffmann U, Cole R, Hunter DJ. abstract
This Framingham CT study found “we failed to find an association between FJ OA, identified by multidetector CT, at any spinal level and LBP in a community-based study population.”
This confirms the necessity for selective facet blocks to define which joints hurt. Xrays that are “normal” are hence just as likely be affected because there is no association between degenerative changes and pain. An insurer saying someone’s Xrays are “normal” and this means they are fine is nothing but a con job.