Skip to main content
SpringerLink
Log in
Book cover

Multidisciplinary Management of Chronic Pain pp 65–84Cite as

Treatments That Have Questionable or Controversial Evidence

  • Chapter

  • 1812 Accesses

Abstract

This chapter does not address the treatment of patients with acute and subacute pain. It does not address patients with a herniated disk with nerve compression and radiculopathy (pain down a nerve distribution in the arms below the elbow and in the legs below the knee) who, on the basis of objective neurological findings of these conditions can benefit from an epidural injection and/or discectomy, if properly selected and motivated. Nor does this chapter address patients with pain from malignant sources, patients receiving appropriate physical or chiropractic therapy who may require opioids to increase participation in their treatment/rehabilitation process or patients who require surgical treatment for traumatic fracture of the limbs or spine to stabilize the fracture towards healing.

What this chapter does address is the use of surgery, injections, other interventions and chronic opioid therapy for patients with chronic pain as we have described and defined it in earlier chapters. For these patients there is questionable evidence despite their widespread use.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   49.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   64.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   64.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  • Abaci, P. (2010). Take charge of your chronic pain. New York: GPP Life.

    Google Scholar 

  • Abelson, R., & Petersen, M. (2003, December 31). An operation to ease back pain bolsters the bottom line, too. New York Times.

    Google Scholar 

  • Aleccia, J. (2013, July 2). Opiate overdose deaths ‘skyrocketed’ in women, CDC finds. NBC News.

    Google Scholar 

  • Al-Faruque, F. (2014, July 1). FDA tightens oversight of pharmacies. The Hill.

    Google Scholar 

  • American Academy of Neurology. (2007, March 5). New guideline: Epidural steroid injections limited in treating back pain. Press release.

    Google Scholar 

  • American Pain Society. (2007). Guidelines for the evaluation and management of low back pain evidence review. Glenview, IL: American Pain Society.

    Google Scholar 

  • Armon, C., Argoff, C., Samuels, J., et al. (2007). Report of the therapeutics and technology assessment subcommittee of the assessment: Use of epidural steroid injections to treat radicular lumbosacral pain. Neurology, 68, 723–729.

    Article  PubMed  Google Scholar 

  • Armstrong, D. (2011, December 27). Epidurals linked to paralysis seen with $300 billion pain market. Bloomberg.

    Google Scholar 

  • Armstrong, D. (2013, April 25). FDA warning on pain injections comes too late for some. Bloomberg Businessweek.

    Google Scholar 

  • Blaszczak-Boxe, G. (2014, June 30). Are doctors performing too many unnecessary knee-replacement surgeries? CBS News.

    Google Scholar 

  • Brawley, O. (2011). How we do harm. New York: St. Martins.

    Google Scholar 

  • Brownlee, S. (2007, October). Newtered. Washington Monthly.

    Google Scholar 

  • Catan, T., & Pereza, E. (2012, December 15). Pain-drug champion has second thoughts. Wall Street Journal.

    Google Scholar 

  • CBS News (2014, July 2). Dr. Max Gomez: New study questions the effectiveness of epidural injections.

    Google Scholar 

  • Chou, R., Loeser, J., Owens, D., Rosenquist, R., Atlas, S., Baisden, J., et al. (2009). Interventional therapies, surgery, and interdisciplinary rehabilitation for low back pain. Spine, 34(10), 1066–1077.

    Article  PubMed  Google Scholar 

  • Deyo, R., & Mirza, S. (2009). The case for restraint in spinal surgery. European Spine Journal, 18(Suppl. 3), 331–337.

    Article  PubMed Central  PubMed  Google Scholar 

  • Eisler, P. (2014, May 22). Older Americans hooked on Rx. USA Today.

    Google Scholar 

  • Elias, P. (2014, August 15). Money laundering charge added to FedEx drug case. Associated Press.

    Google Scholar 

  • Fauber, J. (2011, December 26). Medtronic paid millions to influential UW chairman. Journal-Sentinel.

    Google Scholar 

  • Fauber, J. (2012a, May 29). Narcotics use for chronic pain soars among seniors. Journal Sentinel.

    Google Scholar 

  • Fauber, J. (2012b, October 2). Many injured workers remain on opioids, study finds. Milwaukee Journal Sentinel.

    Google Scholar 

  • Fauber, J. (2012c, October 25). Medtronic helped write, edit positive ‘Infuse’ spine studies. Medpage Today.

    Google Scholar 

  • Fauber, J. (2015, January 12). Studies find little evidence of benefit from long-term opioid use. Most clinical trials haven’t gone beyond 6 weeks. Milwaukee Journal Sentinel.

    Google Scholar 

  • Fauber, J., & Gabler, E. (2012a, May 29). Experts linked to drug firms tout benefits but downplay chance of addiction, other risks. Milwaukee Journal Sentinel.

    Google Scholar 

  • Fauber, J., & Gabler, E. (2012b, May 30). Narcotic painkiller use booming among elderly. Milwaukee Journal Sentinel/Medpage.

    Google Scholar 

  • FDA. (2008, July 1). Life-threatening complications associated with recombinant human bone morphogenetic protein in cervical spine fusion. Public Health Notification.

    Google Scholar 

  • FDA. (2014, July 23). FDA approves new extended-release oxycodone with abuse-deterrent properties. Press release.

    Google Scholar 

  • Fishman, S. (2012). Responsible opioid prescribing. Washington, DC: Waterford Life Sciences.

    Google Scholar 

  • Food and Drug Administration. (2014, April 23). Drug Safety Communication: FDA requires label changes to warn of rare but serious neurologic problems after epidural corticosteroid injections for pain.

    Google Scholar 

  • Friedly, J., et al. (2014). A randomized trial of epidural glucocorticoid injections for spinal stenosis. New England Journal of Medicine, 371, 11–21.

    Article  PubMed  Google Scholar 

  • Gilette, F. (2012, June 6). American pain: The largest U.S. pill mill’s rise and fall. Businessweek.

    Google Scholar 

  • Groopman, J. (2007). How doctors think. New York: Houghton Mifflin.

    Google Scholar 

  • Hadler, N. (2008). Worried sick (pp. 118–123). Chapel Hill: University of North Carolina Press.

    Google Scholar 

  • Hitti, M. (2007, March 5). Steroid shots for back pain don’t work. Professional group advises against epidural steroid shots for chronic back pain. WebMD.

    Google Scholar 

  • Institute of Medicine. (2011). Relieving pain in America. Washington, DC: The National Academies Press.

    Google Scholar 

  • International Association for the Study of Pain. (2013, June). Insight, pp. 19–20. Academies Press.

    Google Scholar 

  • Lee, N., & Vasudevan, S. (2012). Spinal cord stimulation use in patients with failed back surgery syndrome. Pain Manage, 2(2), 135–140.

    Article  Google Scholar 

  • Lowes, R. (2013, September 10). FDA restricts long-term opioid use to combat abuse. Medscape.

    Google Scholar 

  • Lubell, J. (2013, August 12). Groundwork laid for lawsuits over deaths from tainted steroids. American Medical News.

    Google Scholar 

  • Manchikanti, L., Boswell, M., Raj, P., & Racz, G. (2003). The evolution of interventional pain management. Pain Physician, 6, 485–494.

    PubMed  Google Scholar 

  • Manchikanti, L., Candido, K., Kaye, A., Boswell, M., Benyamin, R., Falco, F., Gharibo, C., & Hirsch, J. (2014a). Randomized trial of epidural injections for spinal stenosis published in the New England Journal of Medicine: Further confusion without clarification. Pain Physician, 17, E475–E487.

    PubMed  Google Scholar 

  • Manchikanti, L., Candido, K., Singh, V., Gharibo, C., Boswell, M., Benyamin, R., et al. (2014b). Epidural steroid warning controversy still dogging FDA. Pain Physician, 17(4), E451–E474.

    PubMed  Google Scholar 

  • Medtronic. (2014). Indications, safety, and warnings. Medtronic implantable neurostimulation system. Retrieved from http://professional.medtronic.com/pt/neuro/scs/ind/index.htm#.Up9zl2AYhe4

  • Meier, B. (2013, June 23). Profiting from pain. New York Times.

    Google Scholar 

  • Melzack, R., & Wall, P. (1988). The challenge of pain. New York: Penguin Books.

    Google Scholar 

  • Mintz, H. (2014, May 22). Santa Clara County sues drug makers for hyping painkillers. San Jose Mercury News.

    Google Scholar 

  • Morris, M. (2013, November 14). Emanuel administration probes J&J unit over drug marketing. Crains.

    Google Scholar 

  • O’Keefe, M. (2014, July 12). Feds quietly investigating prescription drug abuse in NFL locker. New York Daily News.

    Google Scholar 

  • Pain Medicine News. (2014, April). Case of large-scale opioid diversion puts hospitals on alert.

    Google Scholar 

  • Pear, R. (2014, August 16). Medicare to start paying doctors who coordinate needs of chronically ill patients. New York Times.

    Google Scholar 

  • Rosenberg, M. (2014, May 15). How big pharma and the FDA drive the opioid addiction epidemic. Reporting on Health. University of Southern California.

    Google Scholar 

  • Rucke, K. (2014, July 9). California, Chicago sue addictive painkiller manufacturers. MintPress News. Retrieved from http://www.mintpressnews.com/california-chicago-sue-addictive-painkiller-manufacturers/193660/

  • Silverman. S. (2014, January 5). Costs to manage pain will go up under Obamacare. Sun Sentinel.

    Google Scholar 

  • The American Academy of Pain Medicine. (2014). AAPM’s 2013 safe opioid prescribing initiative. Retrieved from http://www.painmed.org/safeprescribing/

  • U.S. Senate (2012, October 25). Baucus-Grassley investigation into medtronic reveals manipulated studies, close financial ties with researchers, committee on finance. Retrieved from http://www.finance.senate.gov/newsroom/chairman/release/?id=b1d112cb-230f-4c2e-ae55-13550074fe86

  • Webster, B., Verma, S. K., & Gatchel, R. J. (2007). Relationship between early opioid prescribing for acute occupational low back pain and disability duration, medical costs, subsequent surgery and late opioid use. Spine, 32(19), 2127–2132.

    Article  PubMed  Google Scholar 

  • Wells-Federman, C. L. (1999). Care of the patient with chronic pain: Part I. Clinical Excellence for Nurse Practitioners, 3(4), 192–204.

    PubMed  Google Scholar 

  • Wheeler, A. et al. (2013, January 8). Low back pain and sciatica. Medscape.

    Google Scholar 

  • Wilson, D., & Meier, B. (2009, May 12). Doctor falsified study on injured G.I.’s, Army says. New York Times.

    Google Scholar 

  • Zaniewski, A. (2013, July 29). Two more Michigan deaths linked to tainted steroid injections. Detroit Free Press.

    Google Scholar 

  • Zhao, Z., & Cope, D. K. (2013). Nerve blocks, trigger points, and intrathecal therapy for chronic pain. In R. Moore (Ed.), Handbook of pain and palliative care (pp. 550–556). Rockville, MD: Springer.

    Google Scholar 

  • Zylberger, D. (2009). Facet pain and radiofrequency ablation. Presentation. New York-Presbyterian. Retrieved from http://nyp.org/pdf/1050_Zylberger.pdf

Download references

Author information

Authors and Affiliations

  1. Wisconsin Rehabilitation Medicine Professionals, Milwaukee, WI, USA

    Sridhar Vasudevan

Authors
  1. Sridhar Vasudevan
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Vasudevan, S. (2015). Treatments That Have Questionable or Controversial Evidence. In: Multidisciplinary Management of Chronic Pain. Springer, Cham. https://doi.org/10.1007/978-3-319-20322-5_5

Download citation

Publish with us

Policies and ethics

Search

Navigation