Little relief in back pain ‘quick fix’

“Thousands of Australians with back pain are lining up for “a quick fix” that doesn’t work and can be risky.

Last year 40,000 queued for an injection of steroids into their spine in the hope it would curb pain in their lower back, legs, neck or arms.

That there is no reliable evidence to show these injections are effective seems to make no difference.

That there is strong evidence to show they are not effective also makes no difference…

…This study added yet more fuel to a call last year for the Australian government to withdraw funding of all spinal injections.

The call, published in an article in the Medical Journal of Australia, was made on the grounds that they had only had a placebo effect, could cause harm and were a waste of money.

The article, which canvassed the evidence, was co-authored by Ian Harris, professor of orthopaedic surgery at the University of NSW.”

The outcome of the study is not surprising, but what I find astonishing is that number – 40,000 procedures in one year in Australia alone at a cost of $3.6 million. The world wide numbers and cost must be staggering.

Interesting follow up piece in the online MJA website has Professor Nikolai Bodguk calling for funding to be preserved for lumbar transforaminal steroid injections in cases of  radicular pain to be preserved, but ends with a quite from Professor Milton Cohen:

“Professor Cohen said a “cynical” explanation for this growth was the financial incentive for performing such procedures. ‘There’s a price tag attached to it — you can earn much more for a procedure that might take 5 minutes than you do for an hour-long consultation exploring the biopsychosocial aspects of a person’s [back pain].'”

The first article was posted in the Financial Review, but maybe in the big scheme of things, $3.6million is still not a big enough number for the evidence to direct policy?


-Tim Cocks


5 Responses to “40,000”

  1. davidboltononoi

    Nice one Tim,
    Surely the first reflection of ANY practitioner is ” How can I relieve the suffering of this poor soul” 😗 synical, me !!!!!! No……..

  2. Ian Stevens

    There’s a price tag attached to it — you can earn much more for a procedure that might take 5 minutes than you do for an hour-long consultation exploring the biopsychosocial aspects of a person’s [back pain].’”

    apply that statement to manipulation, ‘acupuncture’ and just about anything else and you might get the same ‘result’ ………….pain clinics are often staffed by interventionists as this is what people are trained and interested in doing . If you want promotion in physiotherapy and are interested in (N) MSK disorders you are much more likely to be well recieved with an injection ticket rather than years of reading about pain …this is the reality of why things as they are ……….In physiotherapy you stil have to serve this kind of unwritten programme of ortho medicine which compounds structural thinking and plays lip service to BPS reasoning ………

  3. Ian Stevens

    Also was thinking of Paul Watsons treatment from the Pain Society when he was advocating not injecting !! Vested interests( not just money) are in the mix when it comes to ‘treatments’ or more likely symbolic gestures deliverd by authority figures (in some instances)

  4. davidbutler0noi

    40,000 injections in Australia probably means half a million or more in the US. That is a lot! Of course the public has to want these injections too. Pharmaceutical ads often include enticing language suggesting that their preparation “gets to the source of pain”. I am sure many people believe that needlepoint must REALLY get to the source.



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