Overtreated. Again.

Came across this story when a physician FB friend posted that he read it the day after getting a steroid injection for his back.  Sadly for him, he won’t even get the placebo effect now:

A randomized trial of steroid injections for back pain has shown that they are no more effective than a placebo.

Because the long-term benefits of surgery remain unproven and pain medicines often have serious side effects, doctors have increasingly turned to steroid injections to treat lumbosacral radiculopathy, a common cause of back pain. The condition stems from damage to the discs between the vertebrae that often leads to sciatica, numbness or pain in the legs.

Researchers tested 84 adults with back pain of less than six months’ duration, dividing them into three groups. They received either steroids, etanercept (an arthritis medicine) or an inactive saline solution in two injections given two weeks apart.

At the end of one month, they were assessed for pain.

Leg and back pain decreased in all three groups, but there were no statistically significant differences among them. The researchers conclude that steroids may provide some short-term analgesic effect, but that the improvement in all of the patients was mainly due to normal healing.

If only people realized how often doctors are just guessing without any research to back up what they are doing.  Unfortunately, when they are not sure whether something will work, it’s safe to say the very often err on the side of what may well be an unnecessary treatment.   This is actually a pervasive and serious problem in our overall medical system and culture in this country.   Alex has several great doctors whom I especially appreciate as they are so honest about how much they don’t know.  When in doubt, treat, may be great for doctors, hospitals, etc., bottom lines, but not necessarily for patients.  And, oh, for that back pain, this conclusion confirms what I’ve been hearing for years:

But for now, he said, “the strongest evidence for back pain relief is with exercise.”

Free, but hard (relative to getting a shot or popping a pill, that is).  In my case, I actually found that simply sleeping with a pillow under my hips (while sleeping on my stomach) was all the cure I needed for the back pain I developed a couple years ago.   Had that not worked, I was planning on working through the exercises in the Back Pain Book.

About Steve Greene
Professor of Political Science at NC State http://faculty.chass.ncsu.edu/shgreene

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