And yet another article on the overuse of epidurals, showing how they are being used to generate more profit for “interventional” pain specialists.
Experts Say Epidural Steroid Injections Overused — Pain News Network – August 19, 2015/ Pat Anson
Epidural steroid injections are being used too often to treat back pain, in part because of an insurance compensation system that encourages doctors to generate more income by using the procedure, several leading experts in pain management have told Pain News Network.
Critics say epidural injections are overused and patients risk permanent damage to their spinal cords if they get the shots too often. Continue reading
Below is another article on the dangers of epidural injections. This procedure isn’t so popular because it bestows benefits on the recipient as much as because insurance companies compensate them so well.
Beware of worthless procedures and epidural steroids for your back pain – KevinMD – Cathryn Jakobson Ramin | Conditions | April 29, 2017
in a 2015 review of the medical literature, the Agency for Healthcare Research and Quality had found no evidence that epidural steroid injections were effective in treating symptoms of spinal stenosis or typical lower-back pain. Continue reading
Potential Risks of Pharmacy Compounding – Drugs R D. – 2013 Mar – free full-text PMC article
Published reports of independent testing by the FDA, state agencies, and others consistently show that compounded drugs fail to meet specifications at a considerably higher rate than FDA-approved drugs.
Pharmacy compounding involves the preparation of customized medications that are not commercially available for individual patients with specialized medical needs. Traditional pharmacy compounding is appropriate when done on a small scale by pharmacists who prepare the medication based on an individual prescription.
the regulatory oversight of pharmacy compounding is significantly less rigorous than that required for Food and Drug Administration (FDA)-approved drugs; as such, compounded drugs may pose additional risks to patients. Continue reading
The Safety of Epidural Steroid Injections: What You Need to Know 05/19/15
I have several posts explaining the dangers of epidural injections, but I’ve heard they can be very effective for a subset of patients. Here is an interview with a proponent of this treatment.
Q: What is an epidural steroid injection?
Dr. Richeimer: This procedure involves injection of corticosteroids into the epidural space around the spinal cord and nerves.
It is most often used to treat spinal disorders of the low back (lumbar spine), and also may be used to treat disorders in the neck (cervical spine).
Interventional Pain Management for Chronic Pain 7/18/16
Injections, Stimulation, Pain Pumps, and Other Treatments
For many people living with chronic pain, finding pain relief can be tough. A lot of trial and error is involved to find a pain treatment that works. Interventional pain management may help chronic pain patients cope with their pain.
what makes interventional pain management different is that it uses techniques, such as injections and radiofrequency rhizotomy, to directly [and invasively] address the source of your pain.
Some conditions interventional pain management techniques commonly treat include: Continue reading
Understanding Potential Complications Of Epidural Steroid Injections
Practitioners need to understand and educate their patients regarding the full scope of potential side effects that can occur when receiving epidural steroids.
Corticosteroids are a common component of nearly all therapeutic injections for pain management that physicians perform.
Whether they are used in a trigger-point injection performed by a primary care physician in an office or in a precision cervical epidural injection performed under fluoroscopic guidance, steroids have become one of the most commonly used injectable pain medications in the United States. Continue reading
Multi-Society Pain Workgroup: Washington State’s Spinal Injections Coverage ‘a Win for Back Pain Patients’ – Pain Medicine News – April 2016
The Multi-Society Pain Workgroup (MPW), representing more than 100,000 physicians and 15 medical societies, has commended the Washington State Health Care Authority’s Health Technology Clinical Committee (HTCC) for preserving access to spinal injection therapies for back pain.
These “pain specialists” are expecting more patients will be submitting themselves to more profitable (for doctors) and dangerous (for patients) invasive “interventional” procedures. Continue reading
So, What IS Pain Management? – National Pain Report | Dr. David Nagel | April 2, 2016
Even medical professionals struggle to agree with what pain management is, and that creates a big problem.
There is a perception that pain management is all about needles and opioids, a perception that is unfortunately based on what happens in the real world.
Needling and prescribing pay well, managing pain does not, so too often pain patients are needled and drugged in a piecemeal fashion with no attempt to look at the big picture of their lives. Continue reading
Unnecessary multiple epidural steroid injections delay surgery for massive lumbar disc: Case discussion and review | Surg Neurol Int. 2015 | Free Full Text PMC Article
From the Conclusions section:
Unfortunately, pain specialists (e.g., radiologists, anesthesiologists, and physiatrists), not specifically trained to perform neurological examinations or spinal surgery, are increasingly mismanaging spinal disease with ESI/variants.
Epidural steroid injections (ESI) in the lumbar spine are not effective over the long-term for resolving “surgical” lesions.
Here, we present a patient with a massive L2–L3 lumbar disk herniation whose surgery was delayed for 4 months by multiple unnecessary ESI, resulting in a cauda equina syndrome. Continue reading
This information is from a PPT slide show created by Terri Lewis, PhD, who has kindly given me permission to post it here:
Interventional pain procedures are increasing more rapidly than opioid prescribing
- Between 2000 and 2013, the use of Interventional Pain Management Procedures increased by 236%. About one half of these procedures were adhesiolysis procedures or epidurals and half were facet joint interventions and SI blocks.
- During this same time the number of opioid prescriptions dispensed by US retail pharmacies climbed 64%, from 126 million to 207 million (the max was in 2010 with 219 million).
While opioid prescriptions increased by 64%, interventional pain procedures increased by 236%. Continue reading