Evaluating Radiofrequency Ablation versus Corticosteroid Injections for Facet Joint Syndrome Causing Chronic Lumbar Back Pain: A Systematic Review with Meta-Analysis of Randomized-Controlled Trials

Purpose Facet joint syndrome (FJS) is a common cause of chronic lumbar back pain (CLBP), significantly impacting patients' quality of life. Among therapies available, radiofrequency ablation (RFA) and corticosteroid injections are widely used; however, limited comparative evidence exists regarding their efficacy, especially for chronic cases affecting the lumbar spine. Therefore, this study seeks to evaluate the effectiveness of radiofrequency ablation and corticosteroid injections in treating facet joint syndrome-related chronic lumbar back pain. Methods A comprehensive search of PubMed, Embase, Web of Science, Cochrane Library, and Scopus was conducted to identify controlled trials evaluating RFA or corticosteroid injections. The primary outcomes measured were Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores at 3 and 6 months. Results Both RFA and corticosteroid injections demonstrated significant improvements in ODI and VAS scores at 3 months (p < 0.001). At 6 months, RFA maintained effectiveness in ODI scores (p = 0.008), while corticosteroid injections showed borderline significance (p = 0.06). Corticosteroids provided greater VAS improvement at 6 months compared to RFA (p = 0.03), though RFA exhibited better-sustained efficacy overall. Conclusion Both RFA and corticosteroid injections are effective treatments for FJS-related CLBP, with RFA providing longer functional benefits and corticosteroid injections providing better pain reduction over time. However, differences in methodologies, patient populations, and intervention protocols highlight the need for further research to clarify their nuanced efficacy for particular situations.