In the Reuters Health News August 20, 2002
issue is a story reporting on a study that says nerve blocks do not do what
they are supposed to do to reduce pain or improve the quality of life.
According to Steven H. Sanders, program director in the psychology
department at the Siskin Hospital for Physical Rehabilitation in
Chattanooga, Tennessee, nerve blocks are often recommended for both acute
and chronic low back pain, but long-term studies of the blocks are scarce.
Dr. Sanders said, "We wanted to see whether (the blocks) made any
difference."
To check the validity of this common
procedure, Dr. Sanders and his group evaluated two groups: 30 patients with
low back pain who received the blocks and 30 with low back pain who did not.
The nerve blocks, more specifically called lumbar sympathetic nerve blocks,
are injected into the area surrounding sympathetic nerves in the lower back.
Most contain either local anesthetic or local anesthetic with corticosteroid
drugs. To help assure that the results were accurate, both groups of
patients had the same treatment except for the nerve blocks. The patients
that got the nerve block had three to six blocks performed. The subjects in
the block and non-block groups were matched as far as age, gender, duration
of pain (which ranged from 2 to 4 years) and previous back surgery. The
patients ranged in age from 43 to 56 years.
The results at the end of 6 months showed
that the patients who received nerve blocks did no better than those who did
not get nerve blocks in terms of pain, reduced use of pain medication, mood
and other issues. The blocks did increase the treatment costs from an
average of $4,500 per patient in the group without nerve blocks to $5,900
for the patients who got nerve blocks. In light of these results Dr.
Sanders comments were that he felt these procedures represented, "a lot
of expense, but no clinical benefits. You have to wonder why you do these
(blocks)."