tag:blogger.com,1999:blog-6193043695356712843.post486544758829397876..comments2023-09-02T23:55:45.583+10:00Comments on Doctor Skeptic: Steroid injections for low back painDr Skeptichttp://www.blogger.com/profile/09376469049519802493noreply@blogger.comBlogger32125tag:blogger.com,1999:blog-6193043695356712843.post-66729789781384726262016-03-17T12:10:35.856+11:002016-03-17T12:10:35.856+11:00i am so pleased to read this. About 15 months ago...i am so pleased to read this. About 15 months ago i began exercising in the pool to build up the muscles around a hip replacement. I go three times a week. I was preparing to have the other hip replaced when i noticed a phenomenal decrease in hip pain and lower back pain. I do various exercises with ankle cuffs and aqua dumbbells plus 25 minutes of treading water. It has been nothing short of astounding. I also got rid of the lounge and replaced it with a firm bed which is much higher and much easier to get up from. I have tried telling my friends, but i am cassandra crying in the wilderness. No one wants to believe this could be a solution.curacaohttps://www.blogger.com/profile/05457521898623967811noreply@blogger.comtag:blogger.com,1999:blog-6193043695356712843.post-63583444197243240642015-06-13T20:14:22.958+10:002015-06-13T20:14:22.958+10:00I have always heard about this but never gave it a...I have always heard about this but never gave it a second thought. I've suffered from back pain for years and have always been on edge when trying new things cause everything I have tried has failed. The only thing that has relieved me back pain was actually exercise. Thanks for sharing this information with us. Sheamushttps://www.blogger.com/profile/05158555199153000678noreply@blogger.comtag:blogger.com,1999:blog-6193043695356712843.post-54363982957522472272014-09-23T18:40:02.560+10:002014-09-23T18:40:02.560+10:00I totally agree with Robbin Connors - would be bes...I totally agree with Robbin Connors - would be best to manage pain through 100% natural way instead of drugs. Great and interesting read. - JenniferBack Painhttp://www.backpaintypes.net/noreply@blogger.comtag:blogger.com,1999:blog-6193043695356712843.post-85697719496385271812014-09-23T14:40:31.330+10:002014-09-23T14:40:31.330+10:00This is really a nice article on Lower back Pain.
...This is really a nice article on Lower back Pain.<br />I too prefer to go for exercise for recovering my pain.Robin Connorshttp://www.thebaydoctor.com/blog/83-advanced-treatment-for-back-pain.htmlnoreply@blogger.comtag:blogger.com,1999:blog-6193043695356712843.post-2612738625242239422014-04-27T06:57:35.709+10:002014-04-27T06:57:35.709+10:00I cannot deny that the incentives to treat are hig...I cannot deny that the incentives to treat are higher in the private sector, but you would also accept that there are spectrums of doctors out there, ranging form conservative to aggressive, and from high to low knowledge of EBM principles, for example.Dr Skeptichttps://www.blogger.com/profile/09376469049519802493noreply@blogger.comtag:blogger.com,1999:blog-6193043695356712843.post-35058637516594960112014-04-26T23:05:42.657+10:002014-04-26T23:05:42.657+10:00Ah Dr Skeptic, can you prove that they are out the...Ah Dr Skeptic, can you prove that they are out there or is it just your opinion? The desire to "help" or "do something" plus concern for what a patient will think or say plus the financial incentive makes it difficult for a private practitioner to follow EBM especially for pain as most/all intervention is no better than placebo. Sorry, run on sentence.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-6193043695356712843.post-32352707883311337112014-04-11T14:14:27.118+10:002014-04-11T14:14:27.118+10:00I have always heard about this but never gave it a...I have always heard about this but never gave it a second thought. I've suffered from back pain for years and have always been on edge when trying new things cause everything I have tried has failed. The only thing that has relieved me back pain was actually exercise. Thanks for sharing this information with us. Jason Hursthttp://doctorspainreliefsystems.comnoreply@blogger.comtag:blogger.com,1999:blog-6193043695356712843.post-12497723925092590262013-12-16T09:56:21.171+11:002013-12-16T09:56:21.171+11:00I don't know exactly how to find them, but I c...I don't know exactly how to find them, but I can tell you that they are out there.Dr Skeptichttps://www.blogger.com/profile/09376469049519802493noreply@blogger.comtag:blogger.com,1999:blog-6193043695356712843.post-34914055546402666072013-12-16T02:39:32.711+11:002013-12-16T02:39:32.711+11:00Just discovered your site and blog...finally a muc...Just discovered your site and blog...finally a much sought after intelligent rational discourse. Where does one find doctors who are guided by science and critical thought rather than their own game of questionable therapy? This is probably a rhetorical question. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-6193043695356712843.post-32297368672671296952013-04-09T14:13:12.642+10:002013-04-09T14:13:12.642+10:00Thanks Douglas, some good points. However, I disag...Thanks Douglas, some good points. However, I disagree with the usefulness of local injections to localise disease. This is notoriously unreliable, and I think the saga of discograms has shown that. Also, if used for localisation of pathology, why not use local anaesthetic only, because I dont' think the steroids do anything?Dr Skeptichttps://www.blogger.com/profile/09376469049519802493noreply@blogger.comtag:blogger.com,1999:blog-6193043695356712843.post-67184235208150391822013-02-19T15:13:28.532+11:002013-02-19T15:13:28.532+11:00Interpreting research findings is an art in itself...Interpreting research findings is an art in itself and it's clear that one must exercise caution whenever a study tries to investigate any intervention for 'back pain.' Without a diagnosis or identifiable tissue in lesion you don't even know what it is you have investigated. <br /><br />To wit injection procedures. If used in conjunction with a history, exam and a clinician who is up to date with the literature you can tell Mr Smith that the benefit will not be sustained (Cochrane) but will give us an opportunity to provide temporary relief, initiate conservative care and confirm a diagnosis (when this proves difficult). After all joint blocks gave us tremendously valuable clinical information so that we can reliably correlate the site of symptoms with the generator without resorting to invasion in the majority of cases. A recent study has suggested that steroid infiltration (early intervention (under 2 months) lateral recess) may reduce neural tethering of the exiting root (a common complication with annular lesions)) and lower the risk of the development of chronic pain. It appears (at this point) that it's use may be limited after the acute inflammatory phase.<br /><br />So yes if read one way the report appears to suggest a blanket rejection of injection but like one review of say 'spinal manipulation' we don't know what was done nor what conditions it didn't appear to work for nor those which responded because there was no diagnosis to begin with. As with the above we can misinterpret and throw the baby out with the bathwater.<br /><br />Regards<br /><br />Douglas Scown<br /><br /><br /><br /><br />Douglas Scownhttps://www.blogger.com/profile/00817333029167847943noreply@blogger.comtag:blogger.com,1999:blog-6193043695356712843.post-27117630985170282892013-01-17T21:54:24.030+11:002013-01-17T21:54:24.030+11:00Thanks James,
Rather than repeating steroid injec...Thanks James,<br /><br />Rather than repeating steroid injections, my point is that they should not e used in the first place. They have no specific (beyond placebo) therapeutic effect and carry a small risk of harm. There are safer and cheaper placebos available.Dr Skeptichttps://www.blogger.com/profile/09376469049519802493noreply@blogger.comtag:blogger.com,1999:blog-6193043695356712843.post-26366647207754808972013-01-17T21:32:51.517+11:002013-01-17T21:32:51.517+11:00Good information shared about steroids injection.B...Good information shared about steroids injection.But Is it safe to take steroid injection every time if a patient is having back pain as their is a possibility of having back pain again.<a href="http://aokemergencyroom.com/back-pain-and-injuries/" rel="nofollow"></a>Anonymoushttps://www.blogger.com/profile/10936023337073785482noreply@blogger.comtag:blogger.com,1999:blog-6193043695356712843.post-2548776727714884752012-12-17T09:53:41.857+11:002012-12-17T09:53:41.857+11:00Thanks for your comment.
It is not my place to of...Thanks for your comment.<br /><br />It is not my place to offer individual advice on a patient that I have not seen, but your question is a common one: "If this treatment is not effective, what should I do?"<br />Depending on the condition, sometimes there are no effective interventions beyond simple analgesics and modifying your activities to minimise the pain. For you particular condition, I recommend getting advice from your doctor.<br /><br />One thing I try to avoid is driving patients from one ineffective treatment to another. Remember that the failure of one particular treatment does not make the next treatment more effective. Each treatment should stand or fall on its own.Dr Skeptichttps://www.blogger.com/profile/09376469049519802493noreply@blogger.comtag:blogger.com,1999:blog-6193043695356712843.post-48498510392631740812012-12-14T00:00:06.345+11:002012-12-14T00:00:06.345+11:00Interesting post about spinal injections. I am sc...Interesting post about spinal injections. I am scheduled to have an injection today, as a matter of fact, to ease the pain being caused by a central protrusion of my disc between L4 and L5. In reading about side effects and now the fact that there is no evidence that the steroid injection is any better than a placebo, I'm considering cancelling the appointment. However, what are some of my alternatives to get relief. The pain in my hip, leg, and groin is becoming unbearable.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-6193043695356712843.post-91185326635548388592012-11-10T15:45:23.155+11:002012-11-10T15:45:23.155+11:00Delighted that I found your site, fantastic info. ...Delighted that I found your site, fantastic info. I will bookmark and try to visit more frequently.new jersey chiropractorshttp://www.totalbodynj.comnoreply@blogger.comtag:blogger.com,1999:blog-6193043695356712843.post-62198911161288591782012-11-06T18:08:32.495+11:002012-11-06T18:08:32.495+11:00Thanks for the post. I had been looking for someth...Thanks for the post. I had been looking for something related and found your web site in the process.. I will definitely be back for more.<br />chiropractors njhttp://www.totalbodynj.comnoreply@blogger.comtag:blogger.com,1999:blog-6193043695356712843.post-90348006761154881072012-11-04T08:43:48.263+11:002012-11-04T08:43:48.263+11:00Thanks, but you offer a biological explanation for...Thanks, but you offer a biological explanation for ... what exactly? The definition of spinal instability is so vague as to be untestable. Back pain is just as common in lazy people as active people, and it is back pain we are interested in, not theoretical "instability" which has no clear clinical definition, let alone any link to back pain.Dr Skeptichttps://www.blogger.com/profile/09376469049519802493noreply@blogger.comtag:blogger.com,1999:blog-6193043695356712843.post-69197498219150351772012-11-04T03:10:58.314+11:002012-11-04T03:10:58.314+11:00The complete lack of movement from every day to da...The complete lack of movement from every day to day life can lead to loss of muscle tone in the lower back which results in loss of stability in the spine.health and wellbeinghttp://www.healthycitiesliverpool.co.uk/noreply@blogger.comtag:blogger.com,1999:blog-6193043695356712843.post-1110040411579106502012-11-02T09:31:08.944+11:002012-11-02T09:31:08.944+11:00Side effects are uncommon, but rare cases of infec...Side effects are uncommon, but rare cases of infection, discitis and even permanent neurological deficit have been reported. Currently, there is an outbreak of fungal meningitis from contaminated steroids in the USA which has caused 29 deaths at this stage (http://www.medpagetoday.com/Neurology/GeneralNeurology/35668?utm_source=breaking-news). Not really acceptable for a placebo in my opinion.Dr Skeptichttps://www.blogger.com/profile/09376469049519802493noreply@blogger.comtag:blogger.com,1999:blog-6193043695356712843.post-92005903586794139432012-11-02T07:25:01.704+11:002012-11-02T07:25:01.704+11:00Thank for sharing. Can you explain what are the si...Thank for sharing. Can you explain what are the side effects for the injection?Chiropractor Mesa AZhttp://www.dobsonbaychiro.com/noreply@blogger.comtag:blogger.com,1999:blog-6193043695356712843.post-42635320360888026392012-10-15T16:44:00.823+11:002012-10-15T16:44:00.823+11:00Once the problem has been isolated and corrected, ...Once the problem has been isolated and corrected, and possibly with more regulations in place, I see no reason why the rate will drop significantly. The same drivers are in place: perception of benefit, placebo effect, patient demand, doctor reliance on 'something', ease of use, low cost etc. etc. The only driver that wil dip in the short term is perceived safety.Dr Skeptichttps://www.blogger.com/profile/09376469049519802493noreply@blogger.comtag:blogger.com,1999:blog-6193043695356712843.post-81378042101053999042012-10-15T16:38:49.281+11:002012-10-15T16:38:49.281+11:00One other thing... I'd be interested in hearin...One other thing... I'd be interested in hearing whether you think the meningitis outbreak will reduce the number of providers who resort to these injections... and/or reduce the number of injections individual providers give.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-6193043695356712843.post-26825848591177640642012-10-15T16:35:32.869+11:002012-10-15T16:35:32.869+11:00Thanks. Very good points. And I appreciate the shi...Thanks. Very good points. And I appreciate the shift you provided in my mindset at the end of your reply. <br /><br />Also, the meningitis story has definitely been on my mind. I remember the day that my surgeon misunderstood something I said and thought I wanted the injection... he left the room to go get it. I could have been one of those people. And I had no idea that the substance he would have injected is compounded by unregulated companies with potentially poor quality control. I thought it was a regular old drug made by a regular old drug company that is subject to the regular old rules and regulations. It's all just very scary. Thanks very much for your reply.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-6193043695356712843.post-25006550925672948502012-10-14T13:33:26.574+11:002012-10-14T13:33:26.574+11:00Most of the studies, and most of the injections, a...Most of the studies, and most of the injections, are lumbar. The theory in the neck is the same (reduce swelling, reduce inflammation etc.). Even if the theory is accepted without proof, it can only lead to a temporary improvement and I would not recommend it. Certainly not at this point in time in NE USA (see http://www.cbsnews.com/8301-204_162-57530886/steroid-injections-tied-to-meningitis-outbreak-may-cause-joint-infection/).<br /><br />Surgery is a much bigger decision, but remember that the severity of your symptoms and the lack of alternative treatments do not make the surgery any more effective, so they are not reasons for surgery. The decision should be made on the likelihood of gaining any benefit, over the likelihood of harm.Dr Skeptichttps://www.blogger.com/profile/09376469049519802493noreply@blogger.com