you can double or
triple that amount."
Who's best suited for
epidural steroid injec-
tions? "People with
clear radicular pain
respond best," says
Steven P. Cohen, MD,
chief of pain medicine
at Johns Hopkins
Medicine in Baltimore,
Md. "A herniated disc
responds better than spinal stenosis, but spinal stenosis responds,
too."
Epidurals are less effective for longtime opioid users who've had
many failed procedures, including back surgery, adds Dr. Cohen, who
also serves as the director of pain research at Walter Reed National
Military Center in Bethesda, Md.
For the most part, steroid injections are cost-effective. The supplies
are minimal, and for an ASC, the facility fee is around $400 depending
on your location, says Dr. Cohen. But the problem is the relief is tem-
porary — on average, the injections last 3 to 6 months — and highly
variable.
2. Radiofrequency ablation.
A more involved, albeit costly,
intervention is the thermal ablation of the nerve. Radiofrequency abla-
tion is a multi-step procedure for chronic pain treatment that uses an
electrical current produced by a radio wave to burn an area of the
nerve that causes pain and thus decrease the pain signals coming from
that area. The first step is a medial branch block, an injection to deter-
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 9
• GAME CHANGER Spinal cord stimulators have proven effective at relieving the
chronic pain of patients who have been suffering the adverse effects of failed back
surgery syndrome for years.
