The facet syndrome is cause by rotational strain to both the facet joints and annulus fibrosus. The sacroiliac joint has a well developed joint space lined by a synovial membrane with normal articular cartilage on the sacral side and a thin layer of fibrocartilage on the iliac side. Dysfunction of the facet joints and sacroiliac joint produce most (45%) of the low back pain, and treatment of such dysfunction consists of analgesics and a few days of bed rest. However, in cases non-responsive to conservative management, injection therapy and manipulation of the facet and sacroiliac joint may be indicated. For patients in whom conservative therapy and manipulation have failed to relieve the symptoms, injection of 1.0% lidocaine or 0.25% bupivacaine with steroid into the facet and sacroiliac joints and overlying muscles, followed immediately by manipulation may be effective. The effect of rendering the area insensitive to pain and of relaxing muscle makes it easier to manage the low back pain. (J Korean Assoc Pain Med 2003;2:132-137)

KeywordsFacet joint, Sacroiliac joint, Low back pain, Intra- articular injection