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Common procedures for chronic spine pain found to offer little to no relief
Medical Xpress / BMJ ^ | Feb. 24, 2025 | Justin Jackson / Xiaoqin Wang et al

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 ...


TOPICS: Health/Medicine
KEYWORDS: back; disc; pain; spine
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To: lee martell

A friend of mine had an epidural when her son was born. She told the doctors she didn’t want an epidural, they did it anyway. Forty years later she still has back pain where they stuck her.
If I ever have a backache, I’ll take back rubs and Doan’s Pills.


21 posted on 03/04/2025 4:10:46 AM PST by Buttons12
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To: doorgunner69

I has two ablations and they did little to nothing to help me. First one seemed to help for about 6 months, then the pain cam back raging. 2nd RF ablation did absolutely nothing. Injections were not much help to no help at all and largely stopped working after about 6 times. What finally got me out of the cycle was seeing a specialist who knew what they hell he was doing and properly diagnosed me. It was my hips/SI joints, not my back causing the bulk of the pain, but because of all the referred pain I couldn’t differentiate where the pain was coming from. I also have stenosis and PSA, getting the PSA diagnosed was helpful, but I’m in a rough cycle trying to get meds straightened out that help and don’t cause the psoriasis plaques to flare out of control.

With nerve ablations, they target the facet nerves (usually), and they can grow back, sometimes in worse locations. It can take up to three ablations to completely kill off the targeted nerves. Depending on how many levels (mine was 3 the first time, 4 the second), you can expect a lot of needles in your spine by the time you’re done. For my insurance I had to go through two diagnostic procedures to get approval for the fist ablation, so by the time I was done, that was 18 needles in my back/spine. Second time was nearly 20 needles all told.


22 posted on 03/04/2025 4:15:56 AM PST by jurroppi1 (The Left doesn't have ideas, it has cliches. H/T Flick Lives)
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To: ConservativeMind

Personal experience here with chronic low back pain. I’m pretty much on a 6 out of 10 pain daily. Started getting the radiated pain down the legs and occasional severe sharp pains..only lasted a 1/2 second but had me flying out of bed or from seated position. Went to a pain management center and I crossed out several pages of paperwork and handed it in. When asked why I did that I said I won’t take any opioids or any other pain medication except ibuprofen which I take 400mg at night to help sleep. I take no prescriptions . Said I was here to get fixed, I’m not looking for a fix. They recommended the epidural and then nerve ablation. I said no.

I went to a chiropractor...a good one not the twist and snap ones. He said I can’t fix that after reading my MRIs and X-ray reports but I should be able to help with the radiated pain issues. 9 months later and that pain is gone. Still have the low back but the other is gone and I’m actually walking better.


23 posted on 03/04/2025 4:16:05 AM PST by maddog55 (The only thing systemic in America is the left's hatred of it!)
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To: ConservativeMind

Kind of tired of repeating myself - my testimony on my
freeper home page or read some books on chiropractic.

I suggest 2 SIMPLE SHORT BOOKS FOR STARTERS:

Chiropractic, the Superior Alternative

Chicken Soup for the Chiropractic Soul


24 posted on 03/04/2025 4:25:21 AM PST by BrandtMichaels ( 1st Peter 4:8 "Above all, love each other deeply because love covers a multitude of sins." )
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To: Libloather

I agree inversions machines are the cheapest least intrusive
application of chiropractic ideals, get the frame straight
all other optimization of health will follow.


25 posted on 03/04/2025 4:28:44 AM PST by BrandtMichaels ( 1st Peter 4:8 "Above all, love each other deeply because love covers a multitude of sins." )
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To: 1st I.D Vet
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.

So what exactly did the doctor do?

26 posted on 03/04/2025 4:35:38 AM PST by A_perfect_lady (The greatest wealth is to live content with little. -Plato)
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To: lee martell

Had nerve block about 15 years ago. Worked like a charm. Will be having another next week — on a different part of the spine.


27 posted on 03/04/2025 4:37:39 AM PST by Bigg Red (My long-time tagline has been removed and will be stored on my home page as it has proved true.)
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To: moonhawk

For later.
Thanks


28 posted on 03/04/2025 5:25:44 AM PST by Big Red Badger (ALL Things Will be Revealed !)
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To: ConservativeMind

I just had an ablation done on my lower back, after the steroid injections and so on provided little relief.
So far I am pain free.
First time in many years.
Its been 2 months.


29 posted on 03/04/2025 5:33:33 AM PST by joe fonebone (And the people said NO! The End)
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To: lee martell

When I got mine they knocked me out to do it..
Xray guided injections.
There was no pain or discomfort involved.


30 posted on 03/04/2025 5:35:06 AM PST by joe fonebone (And the people said NO! The End)
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To: ponygirl
Reformer pilates.

I was walking around my neighborhood in pain, which a neighbor noticed. He said he had had similar problems and recommended a really good physical therapist. Set of exercises that got me on the mend pretty quickly. Basic underlying issue is strength, stretching and flexibility. When I slack off for too long, I start getting warning signs and have to start up again. So long as I keep up I am pain free. Bummer.

31 posted on 03/04/2025 6:21:16 AM PST by AndyJackson
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To: ConservativeMind

I’ve been the gambit. It doesn’t work.


32 posted on 03/04/2025 6:32:49 AM PST by GingisK
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To: ponygirl

Yes...pilates . I had been in a car accident and had lingering, but growing back/hip problems. I asked a chiropracter I was seeing if he thought floor pilates would help. He said, it might. So, I began 2x week Pilates. Never saw the chiro for another 2 years. Did eventually have to return. Fast forward 10 years and still have back/hip issues...sooo...did 40 sessions of hyperbaric last year on the advice of another chiropracter. Hip & back pain basically gone.


33 posted on 03/04/2025 7:13:42 AM PST by goodnesswins (Democracy to Democrats is stealing other peoples money for their use, no matter how idiotic)
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To: BrandtMichaels

Yes, as long as you find a good Chiro ...see post 33.


34 posted on 03/04/2025 7:15:51 AM PST by goodnesswins (Democracy to Democrats is stealing other peoples money for their use, no matter how idiotic)
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To: Wally_Kalbacken

Until you’ve experienced it yourself, most people don’t have any idea what a struggle every day is with back pain. And why it’s easy to get addicted to pain killers.


35 posted on 03/04/2025 7:19:21 AM PST by Ikeon ( Why don't they, do what they say? Say what they mean? One thing leads to another. )
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To: 1st I.D Vet
My issue with it is the same as I have with all Meta-"studies" in that it is not really a study. It is taking a selection of studies that were already done and mixing them together.

This kind of thing rarely produces a useful result.

36 posted on 03/04/2025 7:22:10 AM PST by Harmless Teddy Bear ( Not my circus. Not my monkeys. But I can pick out the clowns at 100 yards.)
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To: CaptainK
That is a very interesting video! It dovetails with a lot of what I have been studying lately, namely, how to process anger correctly. Thanks!

My "thesis" is that many MANY people don't heal correctly EXACTLY BECAUSE we do not know how to deal with/process anger.

Remember, anger is part of the process of healing, as described years ago by Kubler-Ross:
Shock
Denial
ANGER
Bargaining
Acceptance

(and the joke about depression being "anger without enthusiasm" is in the mix too)

37 posted on 03/04/2025 8:35:36 AM PST by spankalib
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To: BrandtMichaels
Great home page FRiend!

...there's about 5-other-kabillion FReepers I wish would do the same ;)

38 posted on 03/04/2025 8:39:04 AM PST by spankalib
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To: spankalib

depression being “anger without enthusiasm”.

Never heard that one before but it’s a gem.


39 posted on 03/04/2025 9:09:53 AM PST by CaptainK ("No matter how cynical you get, it is impossible to keep up” )
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To: goodnesswins
Floor Pilates is good if you are already in pretty good shape and works the large muscles. The Reformer is an assistance device that will support you until you begin to develop muscle tone. This helps to develop the small muscles that will support the bones and joints and tissues surrounding them. Of course, it makes it easy to “cheat” through the movements, but it is up to you how much assistance you require and if you really want to improve. I’ve been doing reformer Pilates since 2018. About 6 months after starting, I went for a hike, the first one following a hot summer, and was surprised how much my balance had improved. Navigating rocky washes and steep hillsides was suddenly a piece of cake, where previously I was relying on a walking stick.

we have had pro athletes in our studio; they’re usually in the higher level classes, while I stick to the lower levels, but when the catcher on our baseball team started being vocal about how much he relied on Pilates and how he had a studio installed in his house, we saw an uptick in those guys coming in. No famous people that I’d heard of, but a few baseball and football players.

40 posted on 03/04/2025 10:14:23 AM PST by ponygirl (Stay gold.)
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