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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.

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Summary

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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