Posted on 03/03/2025 9:12:11 PM PST by ConservativeMind
Researchers found commonly performed interventional procedures for chronic non-cancer spine pain may provide little to no pain relief when compared with sham procedures.
Chronic spine pain, defined as persistent pain along or referred from the spine lasting three months or longer, presents a global health challenge.
While interventional procedures such as epidural steroid injections, nerve blocks, and radiofrequency nerve ablation are frequently used, clinical guidelines have offered conflicting recommendations regarding their effectiveness.
Researchers conducted a comprehensive search.
Eighty-one trials with 7,977 patients were included in meta-analyses out of 132 eligible studies. Patients with chronic axial or radicular spine pain were randomized to receive common interventional procedures or comparators, including sham procedures and usual care.
For chronic axial spine pain, moderate certainty evidence showed that epidural injection of local anesthetic, epidural injection of local anesthetic and steroids, and joint-targeted steroid injection, result in little to no difference in pain relief compared with sham procedures.
Low certainty evidence suggests minimal pain relief differences for intramuscular and joint-targeted injections of local anesthetic, with or without steroids. Intramuscular injection of local anesthetic with steroids signaled that it may actually increase pain.
For chronic radicular spine pain, moderate certainty evidence indicates epidural injection of local anesthetic and steroids and radiofrequency of the dorsal root ganglion are unlikely to result in pain relief. Low certainty evidence suggests epidural injections of local anesthetic or steroids may also yield minimal pain relief.
In physical functioning, moderate certainty evidence shows joint-targeted injections and epidural injections with local anesthetic or steroids probably provide little to no improvement.
Low certainty evidence suggests certain procedures may slightly increase the risk of non-serious adverse events, including joint radiofrequency ablation.
When looking at the substantial cost, inconvenience, and false hope of these common procedures compared to data, it is unclear why they have persisted.
(Excerpt) Read more at medicalxpress.com ...
I can say I know various people who have gotten better with UC-II collagen, disc replacement surgery, chiropractors, losing a fair amount of weight, and even following DDP Yoga videos. There are other medical options, such as stem cell therapy and the Discseel Spine Treatment, among others, but I know no one who had these performed.
Obviously, it would depend on what the source of the pain and problem was.
Even with prety brutal back pain I get sometimes...Advil gives me some fast and good relief.
I wanted to know why and read how it works.
Very intersting and made sense.
I’ve had someo of the procedures mentioned..they never helped..but if they do help other individuals..then great.
I don’t like to use my subjective feelings and impress them on others.
But the experiments you mention include larger groups so that is pretty convincing.
That’s my 2 cents :)
I have had one epidural for back pain.
It would have to be a cold day in Tucson, Arizona before I ever willingly signed up to get another.
It was dreadful. It was torturous. It was supposed to be treatment for pain RELIEF, believe it or not.
Talk about ironic. The procedure obviously does work well for some people. God bless em, but I can only speak from my own experience.
Wonder what hyperbaric would do?
A 20/20 segment where Dr John Sarno cures John Stosell’s chronic back pain.
He also cured my sister's.
Have known several people with back trouble who have gotten better with "epidurals, steroids, and radiofrequency ablation".
They have gone from not being able to twist and bend to being able to move freely.
Everyone can make their own choice in the matter but be cautious of anything that comes from a "meta study". Because mostly what you are being sold is what the bull left in the pasture.
So many back pain issues are not resolved by clinical intervention. In general, very little has been shown to work.
Try a Deep Tissue massage! Can’t hurt, feels nice, and could have a placebo effect.
I have severe back pain that has worsened with age (duh!) and finally got help.
History: compression fracture of lumbar vertebrae 40 + years ago. Spinal fusion and stabilizing rods.
Just lived with it until recently having sharp pains that would cause involuntary curses.
Stretching did little, an MRI showed stenoses (narrowing of the spinal canal). That got the ESI thing going.
Epidural steroid injections (3X) gave relief for several weeks each time. Pain guy says back surgery is overdone and wants to do the RF ablation thing.
All this messing about with my spine is of concern, but I am approaching cripple stage in what I can do other than stand and sit.
Reformer pilates. I have met about 5 different people who had some horrific spine injuries — one a former gymnast who snapped her spine doing a backbend, another a volleyball player who fell back onto the floor and fractured two thoracic vertebrae; another (my good friend) who had all sorts of hardware inserted into her spine to correct scoliosis — who saw amazing improvements after pilates. Several of those people went on to become instructors.
I’ve had more epidural style nerve injections, 5+ ablations, two disk replacements and I’m very thankful for every damn one.
The curious part is the ages of the participants, and if they saw true professionals or guessers who didn’t know spines very well. Case in point I saw multiple spine doctors, went to Stanford, we were chasing multiple pain generators: facet bone on bone, and three badly degenerated discs from time in the military in my 20’s.
Every single one has made significant multi year improvment in my pain and suffering - most notable was the disc replacements as they gave the space needed to prevent vertebrate on vertebrae vice grips to get off my never endings which lead to radiculopathy.
Usually its a multi disc compounding issue rather than one point on the spine that needs attention.
The issue is - as time goes on our discs collapse onto each other rubbing and grinding as our deep neck stabilizer muscles weaken.
Compound any injury where nerve pain causes muscles to atrophy or guarding, its a highly complex 3D shot in the dark that few Dr’s can accurately diagnose.
I went to my final doctor after trying multiple doctors for 5+ years to no effect.
After meeting with him he told me 1: it was fixable and quick, the second to find a new MRI provider as the one I was going to had a shit machine with bad scans which most doctors never even noticed.
1 month later my 10+ year journey with maddening-to-the-point-of-almost-committing-suicide pain levels that would wake me up out of a dead sleep...were gone, like a light switch.
I just had an old army buddy who had similar issues and this same doctor did the same procedure. Same result.
The issue is always the spacing between the discs, and the rubbing and pinching that occurs when joints wear out.
The shots, nerve ablations are usually trying to numb the location of the pain without addressing the structural issues underneath.
Most of the shots are a troubleshooting process to figure out where the pain is actually generated from.
Mix in Health insurance approvals the diagnosis process can take a year for one single pain generating location.
Its bananas, but one that isn’t without and end, and certainly it does help a massive massive amount.
Read this study with caution, the issue is headspace and timing between the vertebrae above and below usually.
I read that book akbout 30 years ago and didn’t have back pain again for years. I need to re-read it. thanks for posting. I really think Sarno is right. Save your money and read the book. On Amazon:
Have you tried cbd gummies? Delta 8? I’d start with 1/2 of a 25mg gummie. And d9nt buy the cheap otc gas staion or pot shop ones.
Bookmark
Older mattresses often sag from the weight of the person. That sag will cause the spine to curve over time, causing pain when the person stands up and the spine must become straight. This would be especially true for people who sleep on their side.
Buying a new firm mattress will allow the spine to rest in a more natural position that will hopefully cause the chronic pain to go away.
-PJ
Inversion tables are great!
I used mine for thoracic and lumbar pain.
Thank you for this info!
For me, a radio frequency nerve burn every six months is the only thing that lets me walk without horrible pain. Chiro made it worse and two surgeons didn’t think they could fix me beyond 50/50 chance of success. Epidural steroids in between nerve burns as needed.
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