For epidural injections, the needle must be placed precisely in this tiny epidural space where the tiniest mistake can nick the spinal cord. Continue reading
Opinion: The Pain Industry’s New & Dangerous FALL-BACK – June 27, 2018 – By Dennis J. Capolongo / Director ENDC
From my perspective, preventative measures to reduce iatrogenic harm should be among the list of alternatives to help reduce opioid consumption.
Recently published reviews authored by outspoken physicians Dr. Martin Makary of John’s Hopkins and Dr. Jana Friedly of the U.W. Medical Center have pointed a finger at an industry that has literally run amok.
Here’s the other nightmare being foisted upon pain patients: “interventional” pain management, with needles and knives that leave patients in even more agony afterward. Continue reading
Neuroinflammation seen in spinal cord, nerve roots of patients with chronic sciatica: Location of inflammation may determine which patients are successfully treated with steroid injections – May 2018 – Massachusetts General Hospital
Another study showing that chronic pain is associated with distinct neurological variations.
A study by Massachusetts General Hospital (MGH) investigators has found, for the first time in humans, that patients with chronic sciatica — back pain that shoots down the leg — have evidence of inflammation in key areas of the nervous system.
In their paper published in the May issue of the journal Pain, the research team reports finding that average levels of a marker of neuroinflammation were elevated in both the spinal cord and the nerve roots of patients with chronic sciatica. Continue reading
Another reason to avoid epidural injections for pain:
In this systematic review and critical literature appraisal, researchers evaluated 8 studies (n=7233) that reported on the effects of epidural steroid injections on bone mineral density, osteoporosis, vertebral fracture, or osteopenia.
And yet another article on the overuse of epidurals, showing how they are being used to generate more profit for “interventional” pain specialists.
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
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
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).
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
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