Spinal interventions for chronic back pain

Despite the common use of spine injections in pain clinics around the world, it has been hard to come up with evidence that strongly supports this practice when applied to chronic back pain (persisting for >3 months). Existing guidelines range from recommending use to recommending avoidance.12345 A new addition to the BMJ Rapid Recommendations series,67 produced by an international team of experts, methodologists, and patients carefully selected to have no conflicts of interest, attempts to correct some of the shortcomings of previous confusing and conflicting evidence synthesis and evidence based guidelines. Most notably, a clear distinction is made between acute and chronic back pain, and the effort involves not just one type of spine pain, but a range of common spine pain conditions and the most common interventions used to treat them. The research and guideline recommendations are worthy of attention, especially the conclusion that spine injections result in little or no …