Scientists are trying to discover who can benefit most before just injecting all patients who have painful and disabiling OA of the joints. Finding the right candidates for the treatment may not be the answer. Perhaps there's an optimal dose per injection or number of injections that are needed for successful results.

New therapies are being studied. One of those is the injection of hyaluronic acid (HA) into the lumbar facet joints. HA has been used with good success in other joints affected by OA.

Most of the trials have been done on large joints such as the hip, shoulder, or knee. The facet joints are much smaller and may require a slightly different approach. One of the first studies using HA in lumbar facet joint arthritis has been published. The results were disappointing as there was no decrease in pain or improvement in function.

More study is needed in this area. HA has been shown to improve the flow of synovial fluid and relieve joint pain in the knee. It is a safe and effective treatment. If the same approach can be refined and perfected for the lumbar spine, it could offer patients an alternative to steroid injections.