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"Injections may banish back pain......" The Times

06th September 2013

....but are they a long term solution?"

This was written in The Times last week

http://www.thetimes.co.uk/tto/health/article3852822.eceSpinal Injections

prompting enquiries from patients.

Whilst a good read, the article misses the point.

The truth is that spinal injections come in many different forms and are only effective when a technically successful injection is applied to the correctly diagnosed painful part.

Many studies have been performed on the outcome of these procedures and some are flawed, giving biased or invalid results.

For example, some studies basket together injections performed by different operators and different tehniques for different indications.

Other studies do not differentiate between injections performed for chronic back pain and those for acute sciatica (lumbar radiculopathy or slipped disc)

There are many well designed research papers that show foraminal epidurals for acute radiculopathy using steroid ARE VERY effective at treating pain in both the short and long term.

They can also help your specialist diagnose what the actual problem is and plan further treatment to help.

The other point is that lumbar facet injections must be used to treat ACUTE pain arising from the facets themselves due to degeneration (wear & tear)of these joints, not CHRONIC pain arising from an undetermined location.

When COMBINED with a robust rehabilitation process or treatment plan, these injections break the patient out of a cycle of acute pain giving rise to less activity and therefore poor muscle tone and cardiac fitness, and subsequently MORE pain.

The injections allow a improvement of the pain over weeks or months so that the patient can engage fully with rehabilitation during that time to break the negative spiral of less activity and more pain.

In the medium to long term then a COMBINATION of these injections AND REHABILITATION are most effective.



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