ABSTRACT
The majority of physicians with a patient in pain will gladly send their patients to the interventionalist, many of whom will also use pain medications, too often, while giving injections. An evaluation of interventional pain medicine literature, using an evidence-based medicine approach, is extremely interesting. The national bill in 2001 for physician charges alone for interventional pain procedures for acute, chronic, and cancer-related pain would be higher than $1.8 billion. One of the questions is whether acute invasive intervention can effectively intervene in a chronic disease process. Many consider chronic pain as a chronic disease that should be treated as one, and are doubtful that a few epidural steroid injections (ESIs) will stop a chronic biological-psychological-social disease process. A review by the Institute for Clinical Systems Improvement looked at fluoro-scopically guided transforaminal ESIs for lumbar radicular pain and found that they are generally safe, but there was insufficient evidence to comment on the efficacy.
