Injections, Epidural

Publication Title: 
European Spine Journal: Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

Patients with a lumbosacral radicular syndrome are mostly treated conservatively first. The effect of the conservative treatments remains controversial. To assess the effectiveness of conservative treatments of the lumbosacral radicular syndrome (sciatica). Relevant electronic databases and the reference lists of articles up to May 2004 were searched. Randomised clinical trials of all types of conservative treatments for patients with the lumbosacral radicular syndrome selected by two reviewers. Two reviewers independently assessed the methodological quality and the clinical relevance.

Author(s): 
Luijsterburg, Pim A. J.
Verhagen, Arianne P.
Ostelo, Raymond W. J. G.
van Os, Ton A. G.
Peul, Wilco C.
Koes, Bart W.
Publication Title: 
BMJ clinical evidence

INTRODUCTION: Over 70% of people in developed countries develop low back pain (LBP) at some time. But recovery is not always favourable: 82% of non recent-onset patients still experience pain 1 year later. Many patients with chronic LBP who were initially told that their natural history was good spend months or years seeking relief. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of oral drug treatments? What are the effects of injection therapy? What are the effects of non-drug treatments?

Author(s): 
Chou, Roger
Publication Title: 
BMJ clinical evidence

INTRODUCTION: Low back pain affects about 70% of people in resource-rich countries at some point in their lives. Acute low back pain can be self-limiting; however, 1 year after an initial episode, as many as 33% of people still have moderate-intensity pain and 15% have severe pain. Acute low back pain has a high recurrence rate; 75% of those with a first episode have a recurrence. Although acute episodes may resolve completely, they may increase in severity and duration over time.

Author(s): 
McIntosh, Greg
Hall, Hamilton
Publication Title: 
BMJ clinical evidence

INTRODUCTION: Herniated lumbar disc is a displacement of disc material (nucleus pulposus or annulus fibrosis) beyond the intervertebral disc space. The highest prevalence is among people aged 30 to 50 years, with a male to female ratio of 2:1. There is little evidence to suggest that drug treatments are effective in treating herniated disc. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of drug treatments, non-drug treatments, and surgery for herniated lumbar disc?

Author(s): 
Jordan, Jo
Konstantinou, Kika
O'Dowd, John
Publication Title: 
Age and Ageing

This guidance document reviews the epidemiology and management of pain in older people via a literature review of published research. The aim of this document is to inform health professionals in any care setting who work with older adults on best practice for the management of pain and to identify where there are gaps in the evidence that require further research.

Author(s): 
Abdulla, Aza
Adams, Nicola
Bone, Margaret
Elliott, Alison M.
Gaffin, Jean
Jones, Derek
Knaggs, Roger
Martin, Denis
Sampson, Liz
Schofield, Pat
British Geriatric Society
Publication Title: 
North Carolina Medical Journal

This issue of the NCMJ addresses the problem of chronic pain in North Carolina; its diagnosis and management in primary and specialty care; and the need to balance efficacy and safety when prescribing opioid medications, as these drugs are associated with significant potential for misuse and abuse. The commentaries in this issue not only address the use of opioids for the management of chronic pain but also explore various alternatives, including medical marijuana, epidural and other injections, surgery, acupuncture, and other integrative therapies.

Author(s): 
Rowe, John
Caprio, Anthony J.
Publication Title: 
The American Journal of Forensic Medicine and Pathology

Treatment for individuals suffering from migraines and pain due to an inflammation or impingement of a nerve range from noninvasive methods such as massage, physical therapy, and medications to invasive methods such as epidural steroid injections and surgery. Each method of treatment has an associated level of risk. While minor to moderate complications from such procedures do occur, deaths are very rare. We report the first cited case of a death associated with the pain management procedure called nerve root block, also referred to as a transforaminal epidural steroid injection.

Author(s): 
Rozin, Leon
Rozin, Roman
Koehler, Steven A.
Shakir, Abdulrezzak
Ladham, Shaun
Barmada, Mamdouha
Dominick, Joseph
Wecht, Cyril H.
Publication Title: 
Age and Ageing

This guidance document reviews the epidemiology and management of pain in older people via a literature review of published research. The aim of this document is to inform health professionals in any care setting who work with older adults on best practice for the management of pain and to identify where there are gaps in the evidence that require further research.

Author(s): 
Abdulla, Aza
Adams, Nicola
Bone, Margaret
Elliott, Alison M.
Gaffin, Jean
Jones, Derek
Knaggs, Roger
Martin, Denis
Sampson, Liz
Schofield, Pat
British Geriatric Society
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

OBJECTIVE: To demonstrate the benefit of cooperation between medical and chiropractic specialists and the usefulness of combining chiropractic and epidural injection in particular cases of back pain. CLINICAL FEATURES: Two cases of low back pain, both with disk protrusions and osteophytic changes, had no response to several weeks of alternate day (or more) chiropractic care. A third case of herniated intervertebral disks and low back pain had no improvement from treatment with epidural steroidal injection.

Author(s): 
Ben-David, B.
Raboy, M.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

OBJECTIVES: To document the efficacy of combined epidural steroid injection (ESI) and manipulation to the lumbar spine in patients suffering from chronic low back pain (LBP). SUMMARY OF BACKGROUND DATA: The use of ESI in conjunction with lumbar manipulation has seldom been reported in the literature but has offered promising results when studied. STUDY DESIGN: Retrospective repeated-measures analysis of patients with chronic LBP who received ESIs combined with spinal manipulation.

Author(s): 
Nelson, L.
Aspegren, D.
Bova, C.

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