America’s opioid crisis is unlike anything else western medicine has had to deal with. It is so profound that common sense would dictate finding an alternative to prescription opioids. One of the first things I think of are injection therapies. Yet injection therapies are not considered a first-line treatment for pain. Why is that?
Injections are pretty common in western medicine. Though there are risks that come with them, the risks are limited. We have been doing injections for so long that they have become routine. And to me, that only further adds to the mystery of why injection therapies are so far down on the list for patients dealing with chronic pain.
What Injection Therapies Do
Injection therapies are fairly routine at Lone Star Pain Medicine in Weatherford, TX. The doctors at Lone Star explain that injections designed to relieve pain rely on a combination of anesthetics and steroid medications. Anesthetics relieve pain while steroids reduce inflammation.
Facet joint injections typify how injection therapies work to relieve pain. A person suffering with back pain as a result of inflammatory disease might be offered the procedure. Facet joint injections involve inserting a needle into the affected joints and injecting medication. The entire procedure takes only 15-30 minutes while pain relief can last anywhere from a few weeks to several months.
Why They Are Not First-Line
Considering the relatively low risk, particularly when compared to prescription opioids, it is peculiar that injection therapies are not prioritized as a primary option for pain management. But Western medicine has its reasons. Based on my research:
1. Non-invasive Therapies Are Preferred
Current medical guidelines prefer non-invasive therapies whenever possible. Even though injection therapies are considered minimally invasive, they are not non-invasive. Therefore, they typically are not recommended as a first-line treatment.
2. Pain Relief Is Only Temporary
As effective as injection therapies can be to relieve pain, the relief they offer is only temporary. However, one could also argue that prescription opioids offer only temporary relief. I see no difference, but medical guidelines draw a distinction between the two.
3. Addressing Underlying Conditions Is More Important
Current medical guidelines also call for addressing underlying conditions that cause chronic pain. Injection therapies do not do that. They are designed only to help manage pain. But then again, prescription opioids don’t address underlying conditions either. So I am still confused.
4. Injections Come With Risks
Some clinicians consider injection therapies second or third-line treatments due to the risks that come with injections. Those risks include infection, tissue damage, and bleeding. I understand those risks, but I also know that the risk factor is comparatively low. It seems that the risks associated with opioid medications are much higher and more severe.
5. The Preference for a Multimodal Approach
Finally, injection therapies are regarded as second and third-line treatments with the understanding that doctors prefer a multimodal approach to managing pain. A multimodal approach combines a variety of non-invasive treatments that could include everything from OTC pain medications to physical therapy to lifestyle changes.
A multimodal approach is reasonable. But I see no reason why injection therapies cannot be part of that approach. It is not as though injections are something new. Injections are not even dangerous when performed by a trained clinician.
As things currently stand, injection therapies are not considered a first-line approach to managing pain. I personally believe that’s a shame, especially given the fact that Western medicine relies so heavily on drugs. I would like to see us taking fewer drugs in favor of more targeted therapies that actually work.