Chronic Back Pain: Other treatments

Don’t I need an epidural steroid injection?
Epidural steroid injections for nonspecific low back pain have been found to be ineffective according to the National Institute for Health and Clinical Excellence in Britain. Their National Health System does not provide reimbursement for these injections anymore. For one-sided pain radiating below the knees, the American Pain Society Clinical Practice Guideline does provide recommendations that an epidural steroid injection can be moderately effective for short term pain relief.
Facet Joint Injections
If your physician recommends says that you have a lot of arthritis in the facet joints in the spine and wants to perform facet injections, be cautious. There has been no form of imaging that has proved capable of identifying painful facet joints. As we age, more people will have arthritis in the facet joints. Up to 25% of some young adults had radiographic evidence of facet arthritis. Nearly 70% of older adults have facet arthritis even without any pain. There was no relationship between facet joint arthritis and low back pain at any spinal level. We understand that the spine changes continuously throughout life and few of the routine changes labeled as “degenerative” have a predictable relationship with pain. The American Pain Society has found good evidence that facet injections are not effective.
Prolotherapy
The American Pain Society has found good evidence that prolotherapy is not effective.
Radiofrequency treatments
The American Pain Society has found good evidence that radiofrequency thermo-coagulation is not effective.
Spinal Traction
A recent Cochrane Collaboration systematic review concluded that there is not enough evidence to recommend any form of traction as a solo treatment.
Laser Treatment
According to National Institute for Health and Clinical Excellence in Britain, laser treatments are not recommended.
Interferential Current
According to National Institute for Health and Clinical Excellence in Britain, interferential current treatments are not recommended.
Ultrasound
According to National Institute for Health and Clinical Excellence in Britain, Ultrasound for pain treatments is not recommended.
TENS (Transcutaneous Electrical Nerve Stimulation)
According to National Institute for Health and Clinical Excellence in Britain, TENS Units are not recommended.
Lumbar Supports
According to National Institute for Health and Clinical Excellence in Britain, lumbar supports are not recommended.
Glucosamine
A recent review found that glucosamine for back pain is not effective.
Intradiscal Electrotherapy Treatment
According to National Institute for Health and Clinical Excellence in Britain, intradiscal electrotherapy treatments are not recommended.

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Department of Orthopedics and Rehabilitation
University of Iowa Hospitals and Clinics
200 Hawkins Drive
Iowa City, IA 52242
319-356-8400