D E C E M B E R 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 8 7
I
n the absence
of antibiotic
alternatives,
physicians in
the early
1900s had no choice
but to treat every infec-
tion with penicillin.
Chronic pain went
through a similar
"penicillin phase." No
matter the type of
back pain — radicular, axial or arthritic — patients got an epidural
steroid injection (and perhaps a recurring script for opioid
painkillers). But with the advent of treatments like radiofrequency
ablation and spinal cord stimulators, pain management is shedding its
penicillin phase.
"Pain management is just starting to come out of that one-size-fits-
all approach to treating patients," says neurologist Vladimir N.
Kramskiy, MD, the director of the Ambulatory Recuperative Pain
Medicine Program at the Hospital for Special Surgery in the Bronx,
N.Y.
With facilities pressed to find opioid-free ways to manage chronic
pain, the timing of these promising interventions couldn't be better.
1. Epidural steroid injections.
Steroid injections in the
Jared Bilski | Senior Associate Editor
Chronic Pain in the Era of the Opioid Crisis
Image-guided interventions like epidural steroid injections,
radiofrequency ablation and spinal cord stimulators are in high demand.
• SAFE AND STEADY With virtually all pain interventions being performed using
some type of image guidance — whether it's X-ray, ultrasound or even CT guidance
— the procedures are safe and easy to perform in an outpatient setting.
Johns
Hopkins
Medicine