IMHO, epidurals are much like many other treatments (traction therapies, enbrill injections, etc...) They have the potential to have a long term benefit in a small percentage of the population and they often have some short term benefit. However, what I see is that SOME, NOT ALL of the purveyors of the technology overuse it in a very gross fashion. I've spoken to too many people who've gotten ZERO relief from 2 ESI's and have still been given a third in the same location. I've spoken to too many people who've gone to VAX-D or DRX-9000 traction therapy and told that their case is so bad that they'll really need to complete all 20 treatments to realize any benefit... oh yes... it may make you worse at first... that'll be $4,000 out of pocket please.
I know a few people with good results, but for every one I know that has a good result, I know many, many more without.
Having said that... I believe that intelligently applied, ESI's are an appropriate tool in the arsenal and some of my 8 ESI's were of great short-term benefit. When I was in the situation where my pain was episodic, ESI's saved vacations and allowed me to function better and recover from a flare-up more quickly. Once you get to the point where the DDD is advanced and there are real structural problems., it's just a symptom masker... but of benefit for some.
I know a couple of people with good result from traction, but in my experience, these successes are few and far between.
Also... when the choice is between fusion and conservative treatment, we'll do more conservative treatment before pulling the trigger on surgery. As our surgical options improve, hopefully it will become a more reasonable option to fix the problem and not let things get worse, earlier in the degenerative cascade.
Just my 2 cents... all the best,
Mark
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