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European Respiratory SocietyInterventional Pain Management2026advanced

Updated 2026 Comprehensive Evidence-Based Guidelines for Facet Joint Interventions in the Management of Chronic Spinal Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines.

Published by American Society of Interventional Pain Physicians (ASIPP) · Modified ASIPP approach, Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology, and Agency for Healthcare Research and Quality (AHRQ) methods.

37Recommendations

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Summary

AI-generated

These 2026 clinical guidelines, developed by a multidisciplinary panel convened by ASIPP, provide evidence-based recommendations for diagnostic and therapeutic facet joint interventions in the management of chronic spinal pain. The panel utilized a modified Delphi consensus technique with an 80% agreement threshold, formulating 37 recommendations covering diagnosis, treatment, sedation, concurrent antithrombotic therapy, and precautions under special clinical circumstances.

Facet Joint InterventionsChronic Spinal Pain

Key Takeaways

1
Chronic axial spinal pain is a major contributor to disability and healthcare expenditures, with facet joints recognized as an established source of pain [1].
2
A total of 37 recommendations were developed with 100% acceptance among the voting panel [2].
3
A modified Delphi technique was utilized to minimize bias, requiring at least 80% agreement among eligible panel members for inclusion [1].
4
For diagnostic and therapeutic interventions, the level of evidence ranged from II to III with moderate to strong recommendations [2].
5
These guidelines represent the best available evidence but do not constitute inflexible treatment recommendations or a standard of care [3].

What's New in This Version

This document represents the updated 2026 guidelines [4].

Scope & Objectives

Clinical Topic

Facet Joint Interventions

Objectives

To provide evidence-based guidance in performing diagnostic and therapeutic facet joint interventions.

Target Patient Population

Patients with chronic spinal pain / chronic axial spinal pain.

Target Providers

Interventional Pain Physicians

Patient Criteria & Setting

Therapeutic Area

Chronic Spinal Pain

Guideline Scope

DiagnosticTherapeutic

Care Settings

Pain Management Centers

Evidence Grading

System: Modified ASIPP approach, Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology, and Agency for Healthcare Research and Quality (AHRQ) methods.

Evidence Levels

diagnostic_and_therapeutic_interventionsThe level of evidence ranged from II to III [2].

special_considerations_and_safety_assessmentsThe level of evidence ranged from II to V [2].

Recommendation Strength

diagnostic_and_therapeutic_interventionsAssociated with moderate to strong recommendations [2].

Authors & Contributors

Pain Management Centers of AmericaPaducahKY

Guideline Features

Based on systematic reviewMultidisciplinaryPatient involvementDrug interactions discussed

Learning Context

Difficulty

advanced

Learning Paths

Facet Joint InterventionsChronic Spinal PainASIPP Guidelines

Read Full Guideline

American Society of Interventional Pain Physicians (ASIPP)

AI Podcast

Deep-dive audio (~10 min)

Study Guide

Structured study document

Infographic

Visual overview of key points

Slide Deck

Presentation-ready slides

Guideline Info

SocietyEuropean Respiratory Society

Full nameAmerican Society of Interventional Pain Physicians (ASIPP)

SpecialtyInterventional Pain Management

Year2026

Evidence systemModified ASIPP approach, Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology, and Agency for Healthcare Research and Quality (AHRQ) methods.

RegionInternational

LanguageEnglish

Key Figures

Recommendations37

Clinical Areas

Interventional Pain ManagementPain Medicine

European Respiratory Society

International

American Society of Interventional Pain Physicians (ASIPP)

All European Respiratory Society guidelines