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

[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.

[goodnesswins]

By reformer, do you mean the machines?

[GOPJ]

bump for later

[Faith65]

BFL

[ponygirl]

Yes.

[jpp113]

I have had the lower back RF Ablation a couple times now. It lasts about 2 years on average (it was almost to the day in my case) and they just redo it. Best my back has felt in 40+ years. No complications either. I have also had it done on my neck vertebrae nerves as well a couple times. Same result. Back injuries + lyme disease years ago and alot of arthritis.

[doorgunner69]

Thanks for the ray of hope.

Have to admit the MRI images of my back are scary. Still see the fractured vertebra.

No idea why after all these years it started acting up.

[goodnesswins]

Ah, yes...I did machine pilates for awhile...until I figured out (after a vacation) that it was killing my back.

[right way right]

Having a back fusion done last July made it possible for me to stand for periods and walk my dog and exercise again, even though my back still hurts, I believe it was very much worth it.
I was almost crippled.
Chiro care was helpful until a disc blew out and would not heal.
Now I may get surgery my neck.