The American Society of Interventional Pain Physicians (ASIPP) just released an update to its guideline on managing chronic spinal pain through facet joint interventions. The guideline, Facet Joint Interventions in the Management of Chronic Spinal Pain, provides updated, evidence-based guidance regarding therapeutic facet joint interventions. With an intended audience of interventional pain physicians and surgical specialists, the guideline features recommendations regarding non-interventional and interventional diagnosis, special considerations, and more. 

Today, we are taking a look at key recommendations from the therapeutic facet joint interventions section of the new 2026 ASIPP guideline. To view all the recommendations, check out the full-text version of the 2026 ASIPP guideline Facet Joint Interventions in the Management of Chronic Spinal Pain. 

  • Radiofrequency Ablation (RFA): The level of evidence is II with moderate strength of recommendation for the clinical effectiveness of cervical RFA. The level of evidence is III with weak to moderate strength of recommendation for the clinical effectiveness of thoracic RFA. The level of evidence is II with moderate strength of recommendation for the clinical effectiveness of lumbar RFA.
  • Therapeutic Intraarticular Injections: The level of evidence is III for short-term improvement and V for long-term improvement, with weak strength of recommendation for the clinical effectiveness of cervical intraarticular facet joint injections. The level of evidence is III with weak to moderate strength of recommendation for the clinical effectiveness of thoracic intraarticular facet joint injections. The level of evidence is IV with weak strength of recommendation for the clinical effectiveness of lumbar facet joint intraarticular injections.
  • Therapeutic Facet Joint Nerve Blocks: The level of evidence is II with moderate strength of recommendation for the clinical effectiveness of therapeutic cervical facet joint nerve blocks. The level of evidence is II with moderate strength of recommendation for the clinical effectiveness of thoracic therapeutic facet joint nerve blocks. The level of evidence is II with moderate strength of recommendation for the clinical effectiveness of therapeutic lumbar facet joint nerve blocks.

The ASIPP anticipates updating this guideline again within the next five years.

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