Back-pain guidelines may delay treatment

BALTIMORE, July 28 (UPI) -- Skipping long-held diagnostic guidelines may speed up pain relief for some with back pain, U.S. researchers say.

Study leader Dr. Steven Cohen of the Johns Hopkins University School of Medicine suggests slavishly following guidelines for diagnosing arthritis-related back pain may also result in wasteful spending.

Diagnostic nerve block tests have been used to prove the arthritis connection before recommending radiofrequency denervation treatment, which non-invasively interrupts nerve-pain signals, Cohen says.

Cohen led a randomized study of 151 patients with back pain and found more than 30 percent of the one-third of patients receiving radiofrequency denervation treatment without doing any nerve block tests had pain relief lasting at least three months.

In another one-third of study patients receiving one positive nerve block test before treatment 16 percent improved. In the last one-third of patients who underwent two nerve block tests 22 percent improved. Cost per successful treatment was $6,286 in the group without tests: $17,142 for the one-test group and $15,241 for the two-test group.

"The whole way we're doing this is wrong," Cohen says in a statement. "If we just do the radiofrequency procedure first, we're going to help more people and we're going to save a lot of money."

The study is published in Anesthesiology.