Epidural Corticosteroid Injections for Radiculopathy and Spinal Stenosis
Authors: Timothy P. Maus, Belinda S. Duszynski
Journal: Annals of Internal Medicine (2016)

Letters3 May 2016Epidural Corticosteroid Injections for Radiculopathy and Spinal StenosisTimothy P. Maus, MD and Belinda S. Duszynski, BS, on behalf of Multisociety Pain WorkgroupTimothy P. Maus, MDFrom Mayo Clinic, Rochester, Minnesota, and Spine Intervention Society, Hinsdale, Illinois. and Belinda S. Duszynski, BSFrom Mayo Clinic, Rochester, Minnesota, and Spine Intervention Society, Hinsdale, Illinois., on behalf of Multisociety Pain WorkgroupAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-0564 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The publication by Chou and colleagues (1) raises significant concerns among physicians treating patients with radicular pain and associated functional impairment. Fourteen medical societies formulated a consensus response to the Agency for Healthcare Quality and Research's technology assessment, the basis of the current publication, addressing the flawed methodology and resulting aberrant conclusions (2).The authors assert the nihilistic position, without evidence, that back and leg pain are not attributable to a specific cause, and they therefore included studies with patient selection by symptoms, not diagnosis. Current literature demonstrates that radicular and somatic back pain can be specifically ...References1. Chou R, Hashimoto R, Friedly J, Fu R, Bougatsos C, Dana T, et al. Epidural corticosteroid injections for radiculopathy and spinal stenosis: a systematic review and meta-analysis. Ann Intern Med. 2015;163:373-81. [PMID: 26302454]. doi:10.7326/M15-0934 LinkGoogle Scholar2. Multisociety Pain Work Group. Letter to Elise Berliner, PhD, Agency for Healthcare Research and Quality. 29 July 2015. Accessed at http://1515docs.org/pdfs/MPW_Letter_to_AHRQ_7-29-2015.pdf on 10 March 2016. Google Scholar3. DePalma MJ. Diagnostic nihilism toward low back pain: what once was accepted, should no longer be [Editorial]. Pain Med. 2015;16:1453-4. [PMID: 26218010] doi:10.1111/pme.12850 CrossrefMedlineGoogle Scholar4. Deyo RA, Dworkin SF, Amtmann D, Andersson G, Borenstein D, Carragee E, et al. Report of the NIH Task Force on research standards for chronic low back pain. Pain Med. 2014;15:1249-67. [PMID: 25132307] doi:10.1111/pme.12538 CrossrefMedlineGoogle Scholar5. MacVicar J, King W, Landers MH, Bogduk N. The effectiveness of lumbar transforaminal injection of steroids: a comprehensive review with systematic analysis of the published data. Pain Med. 2013;14:14-28. [PMID: 23110347] doi:10.1111/j.1526-4637.2012.01508.x CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Mayo Clinic, Rochester, Minnesota, and Spine Intervention Society, Hinsdale, Illinois.Note: Fourteen societies are represented on the Multisociety Pain Workgroup: American Association of Neurological Surgeons, American Academy of Pain Medicine, American Academy of Physical Medicine and Rehabilitation, American College of Radiology, American Pain Society, American Society of Anesthesiologists, American Society of Neuroradiology, American Society of Regional Anesthesia and Pain Medicine, American Society of Spine Radiology, Congress of Neurological Surgeons, Spine Intervention Society, North American Neuromodulation Society, North American Spine Society, and Society of Interventional Radiology. These societies endorsed but did not author this letter. All the societies reviewed and received approval of their Board of Directors to sign on to this letter.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L15-0564. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEpidural Corticosteroid Injections for Radiculopathy and Spinal Stenosis Roger Chou , Robin Hashimoto , Janna Friedly , Rongwei Fu , Christina Bougatsos , Tracy Dana , Sean D. Sullivan , and Jeffrey Jarvik Epidural Corticosteroid Injections for Radiculopathy and Spinal Stenosis Laxmaiah Manchikanti , Alan David Kaye , and Joshua A. Hirsch Epidural Corticosteroid Injections for Radiculopathy and Spinal Stenosis Irbaz Bin Riaz and Robert G. Badgett Epidural Corticosteroid Injections for Radiculopathy and Spinal Stenosis Denis F. Darko Epidural Corticosteroid Injections for Radiculopathy and Spinal Stenosis Roger Chou , Robin Hashimoto , and Janna Friedly Metrics 3 May 2016Volume 164, Issue 9Page: 633-634KeywordsDiagnostic radiologyDisclosureHealth care quality assessmentLower back painPopulation statisticsRehabilitation medicineResearch quality assessmentSpineStenosisSurgeons ePublished: 3 May 2016 Issue Published: 3 May 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...