Lumbar facet joint pain cannot be reliably diagnosed clinically, the International Spinal Injection Society recommends two diagnostic local anaesthetic blocks before radiofrequency (RF) denervation [1].

Scoring systems may improve diagnostic accuracy. The two most popular scores disagree on the interpretation of pain induced by extension/rotation:

‘Cochin Criteria’ [2]: pain on extension/rotation _ not facet joint problem

Helbig & Lee [3]: pain on extension/rotation _ facet joint problem

Methods: Retrospective study of all patients who had RF denervations of the lumbar facet joints in 2004.

Patients were selected clinically and did not undergo diagnostic blocks.

Cochin criteria, Helbig & Lee scores, work status, and outcome were taken from the case notes.

Likelihood ratios were calculated for the scores, their individual components, and work status.

Results: 145 patients underwent RF facet joint denervation, for 127 all data was available. In 68 patients the procedure was successful (53.5%).

Conclusion: Neither the Cochin Criteria nor the Helbig & Lee score can predict the response to radiofrequency denervation of the lumbar facet joints.

Pain on extension/rotation weakly indicates a poor response to facet joint denervation.

X-rays do not help with the diagnosis.

Social factors may be more important than clinical signs.