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Spinal injections: evidence and funding

Your patients are our members. They deserve safe, effective, clinically evidenced care that brings them real benefit and value.  

For this reason, we’ve reviewed the spinal injections offered to our members and the supporting clinical evidence for these procedures.

You can read below our latest funding provisions for specific procedures and the evidence base to support this position.

For queries on these provisions please contact specialistrelationships.health@axahealth.co.uk

Spinal injections: evidence and recommendations

Please note NICE recommendation on invasive treatments for low back pain and sciatica:

Spinal injections

1.3.1 Do not offer spinal injections for managing low back pain

Relevant documents: NICE NG59 2016. Low back pain and sciatica in over 16s: assessment and management (NG59). London.

Please note key feature of the National Low Back and Radicular Pain Pathway 2017: 

To de-commission treatments which are recommended against by NICE 2016 such as acupuncture, therapeutic injections for back pain including facet joint injections, TENS and other treatments.

NICE recommendation

Expected practice

Please follow these provisions when offering therapeutic injections into spine to our members.

Facet joint procedures

  • We don't provide benefit for therapeutic facet joint injections into the cervical, thoracic or lumbar spine
  • We treat these procedures as 'unproven'. (See section 3.2 of our Billing Principles for an explanation of this term)
  • We classified codes A5773, A5774 and A5775 as unproven in the  Important Changes (February 2024) section of our Schedule of Procedures and Fees
  • We should remind you that AXA Health's plans don't cover chronic conditions. Please expect us to apply the terms of our members' plans to the number of injections we'll authorise.

Procedures in scope

Facet joint procedures 

Facet joint injection 

  • A5773 Facet joint injection +/- image guidance (including bilateral) cervical
  • A5774 Facet joint injection +/- image guidance (including bilateral) thoracic 
  • A5775 Facet joint injection +/- image guidance (including bilateral) lumbar