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For Back Pain, Steroid Shots No More Effective Than Placebo

  • 1.  For Back Pain, Steroid Shots No More Effective Than Placebo

    Posted 04-28-2012 13:55
    A very interesting article with a link to the journal where it was published. ---------- [image: The New York Times] [image: E-mail This] * HEALTH * | April 27, 2012 * Well: For Back Pain, Steroid Shots No More Effective Than Placebo * By NICHOLAS BAKALAR A randomized trial of steroid injections for back pain has shown that they are no more effective in relieving discomfort than a placebo. http://well.blogs.nytimes.com/2012/04/27/for-back-pain-steroid-shots-no-more-effective-than-placebo/ Copyright 2012 The New York Times Company | Privacy Policy Bob -- Robert H. Taylor M.A., L.P.C., C.R.C., C.D.M.S., C.L.C.P. Vocational Diagnostics, Inc 3030 N. Central Ave., Suite 406 Phoenix, AZ 85012 (602) 285-0625 (800) 444-4VDI (4834) Fax (602) 264-4838 Prescott, AZ office: 1987 Haven's End Prescott, AZ 86305 (928) 778-7602 (800) 444-4VDI (4834) Fax (928) 771-2860 www.vocationaldiagnostics.com Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. Effective February 2010, Business Associates of Covered Entities must be able to demonstrate that they are in compliance with administrative, physical, and technical safeguards of the HIPAA Security Rule, as required by the HITECH Act. In order to comply with this requirement, VDI utilizes encrypted email when emailing HIPAA-regulated information. Thus, if this e-mail contains HIPAA protected health information (PHI), shortly you will receive an email from me that will have a message from AppRiver asking you to create a user name and password in order to retrieve my email and it's contents/attachments. Doing so is easy, but please be sure you make a note your user name and password, as you will need it again in the future each time I send HIPAA-regulated materials to you. -- Robert H. Taylor M.A., L.P.C., C.R.C., C.D.M.S., C.L.C.P. Vocational Diagnostics, Inc 3030 N. Central Ave., Suite 406 Phoenix, AZ 85012 (602) 285-0625 (800) 444-4VDI (4834) Fax (602) 264-4838 Prescott, AZ office: 1987 Haven's End Prescott, AZ 86305 (928) 778-7602 (800) 444-4VDI (4834) Fax (928) 771-2860 www.vocationaldiagnostics.com Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. Effective February 2010, Business Associates of Covered Entities must be able to demonstrate that they are in compliance with administrative, physical, and technical safeguards of the HIPAA Security Rule, as required by the HITECH Act. In order to comply with this requirement, VDI utilizes encrypted email when emailing HIPAA-regulated information. Thus, if this e-mail contains HIPAA protected health information (PHI), shortly you will receive an email from me that will have a message from AppRiver asking you to create a user name and password in order to retrieve my email and it's contents/attachments. Doing so is easy, but please be sure you make a note your user name and password, as you will need it again in the future each time I send HIPAA-regulated materials to you.


  • 2.  RE: For Back Pain, Steroid Shots No More Effective Than Placebo

    Posted 04-28-2012 14:13
    Thanks Bob Bill Wm. R. Goodrich, CRC, CCM, CLCP, ABVE-D, NCC, AAPM-F Life Care Services/National Life Care Institute Mail:  2814 Brooks Street, PMB 343 Physical:  3309 Brooks Street, Ste. C   Missoula, Montana 59801 (406) 721-9320 (800) 322-9320 Fax (406) 549-5305 http://www.nationallifecareservices.com    Confidentiality Confidentiality Statement: WARNING! "Unauthorized interception of this electronic mail communication could be a violation of Federal Law."  The documents accompanying this electronic mail transmission contain confidential information belonging to the sender which is legally privileged.  This information is intended only for the use of the individual(s) or entity/entities named above.  If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of this electronic mail information is strictly prohibited.  If you have received this electronic mail in error,  please immediately notify us by telephone at the numbers listed above.


  • 3.  RE:For Back Pain, Steroid Shots No More Effective Than Placebo

    Posted 04-28-2012 16:17
    I agree that this is a very interesting question.  (I have one doctor in my area who recommends at least nine of them for every plaintiff!)  I would note, though, that the Conclusion's wording in the Journal's Abstract ( www.annals.org/content/156/8/551.abstract ) seems a little less newsworthy than the wording in the NYT writeup:

              Conclusion:
    Epidural steroid injections may provide modest short-
              term pain relief for some adults with lumbosacral radiculopathy, but
              larger studies with longer follow-up are needed to confirm their benefits.

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    Steve Bast
    Westwind Consulting, Inc.
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  • 4.  RE:For Back Pain, Steroid Shots No More Effective Than Placebo

    Posted 04-29-2012 09:46
    I must reply to this from a personal and professional perspective.  I personally received a full year of pain free state after a single ESI.  This was the first time I was pain free for more than 18 years.  Although I ultimately required surgery two years later, the ESI achieved the desired results and bought time. Likewise, I have worked with hundreds of patients who have been able to avoid surgery all together for more than a decade until such time that disc resorption was seen and pain relief afforded an opportunity for therapy to work. This only goes to show that it behooves us to read all of the outcome studies.

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    Dan Bagwell
    Medical Case Manager
    dmbhome@swbell.net
    San Antonio, TX United States
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  • 5.  RE:For Back Pain, Steroid Shots No More Effective Than Placebo

    Posted 04-30-2012 14:33
    As one quite involved with those receiving rehab and pain management,  there are an array of variables that  impact on the effectiveness of an injection or the like.  Understand that the physician who injects must have great expertise in getting the spot accurately whether under xray or not and I believe this is minimized.  Even to to establish who is a candidate is an art! Then there is the plan for how much rest and therapy must be accurate and monitored.  Of course understanding on the  impact of multiple injections (re: integrity of tissue/tendons etc) is critical as well. 

    -------------------------------------------
    Arlette Loeser, OTR, ATP, CIE/P, CAPS, CDMS, CLCP
    aloeser@advancedlcp.com
    New York, NY United States
    -------------------------------------------




  • 6.  RE: lcp summit

    Posted 05-07-2012 10:13
    Just returned from the Summit in Dallas and wanted to say Hats-off to Cloie Johnson and the rest of the Summit planning committee for such a wonderful summit! Consensus was reached on many items and LCP practice will be better for it. I am still flying high from the historic nature of the gathering-for those who were not able to attend, leaders from AANLCP, FLCPR, ICHCC, IALCP/IARP held a town hall meeting, and following the request of participants, met to see if any common ground could be found. The groups agreed to a dialogue further to address commonalities and collaboration rather than the divisiveness that has been present among the varying life care planning groups for so long. Thanks to all who participated in this-Nancy Zangmeister and Joan Schofield from AANLCP, Susan Grisham and Chris Reid from FLCPR, Sherry Latham and Evelyn Roberts from ICHCC, and Elizabeth Davis and Steve Yuhas from IALCP/IARP. I am so looking forward to the results of this collaboration. The practice of LCP will be stronger for it. Angie


  • 7.  RE:lcp summit

    Posted 05-07-2012 10:27

    Thank you all for your hard work.  It sounds like we were well represented with some dedicated leaders in our field.
    Looking forward to learning more about your recommendations.

    Suzanne
    -------------------------------------------
    Suzanne Langroth, Legal Nurse Consultant, Life Care Planner
    RN, LNCC CNLCP
    slangroth@hbss.net
    Cataula, GA United States
    -------------------------------------------








  • 8.  RE:lcp summit

    Posted 05-07-2012 10:30
    Great news about the summit!  When and how will the outcomes and discussions be shared?
    Thanks,
    Arlette

    -------------------------------------------
    Arlette Loeser, OTR, ATP, CIE/P, CAPS, CDMS, CLCP
    aloeser@advancedlcp.com
    Avon, CT
    New York, NY
    -------------------------------------------








  • 9.  RE: lcp summit

    Posted 05-07-2012 10:43
    We are working diligently to write up the proceedings - they will be published in the (next hopefully) Journal of Life Care Planning and Nancy Zangmeister and I will co-author a piece for the AANLCP Journal as well. I can not tell you how pleased I am with the efforts of so many who worked so hard this weekend. The attendees spoke and the leadership listened. A very encouraging weekend for sure for all life care planners. Best regards to all Cloie Cloie B. Johnson, MEd cloie@osc-voc.com OSC Vocational Systems Inc. 10132 NE 185th St. Bothell, WA 98011 425-949-4406 direct dial 425-486-8701 fax Great news about the summit! When and how will the outcomes and discussions be shared? Thanks, Arlette ------------------------------------------- Arlette Loeser, OTR, ATP, CIE/P, CAPS, CDMS, CLCP aloeser@advancedlcp.com Avon, CT New York, NY -------------------------------------------


  • 10.  RE: lcp summit

    Posted 05-07-2012 11:32
    What a worthwhile weekend. Hats off to all of our leaders and Cloie, next time you come to south Louisiana, you get an extra batch of crawfish. Carla, I believe that the donation is for the research foundation. Someone correct me if I'm wrong. One last thing....I still feel Sheri walking around these meetings. I miss her........... Bob Gisclair


  • 11.  RE: lcp summit

    Posted 05-07-2012 11:41
    Yes. Donations for the Foundation for LCP Research is Through the following: flcpr2@me.com Foundation Address: Foundation for Life Care Planning 10 Windsormere Way Ste. 400 Oviedo, FL. 3276 Phone 407-977-3223 Thanks Bob. I love catfish!! Cloie Cloie Johnson, MEd cloie@osc-voc.com OSC Vocational Systems Inc 10132 NE 185th St Bothell, WA 98011 425-949-4406 direct dial 425-486-8701 fax Sent from my iPhone On May 7, 2012, at 8:32 AM, "Bob Gisclair" wrote: > > What a worthwhile weekend. Hats off to all of our leaders and Cloie, next time you come to south Louisiana, you get an extra batch of crawfish. > > Carla, I believe that the donation is for the research foundation. Someone correct me if I'm wrong. > > One last thing....I still feel Sheri walking around these meetings. I miss her........... > > Bob Gisclair > >


  • 12.  RE: lcp summit

    Posted 05-07-2012 10:43
    We are working diligently to write up the proceedings - they will be published in the (next hopefully) Journal of Life Care Planning and Nancy Zangmeister and I will co-author a piece for the AANLCP Journal as well. I can not tell you how pleased I am with the efforts of so many who worked so hard this weekend. The attendees spoke and the leadership listened. A very encouraging weekend for sure for all life care planners. Best regards to all Cloie Cloie B. Johnson, MEd cloie@osc-voc.com OSC Vocational Systems Inc. 10132 NE 185th St. Bothell, WA 98011 425-949-4406 direct dial 425-486-8701 fax Great news about the summit! When and how will the outcomes and discussions be shared? Thanks, Arlette ------------------------------------------- Arlette Loeser, OTR, ATP, CIE/P, CAPS, CDMS, CLCP aloeser@advancedlcp.com Avon, CT New York, NY -------------------------------------------


  • 13.  RE:lcp summit

    Posted 05-07-2012 11:12
    Ditto in regard to Cloie's and everyone's involvement and hard work.  I enjoyed being part of the process.

    Could someone clarify if it was the Academy or ICHCC that was requesting the donation for research?

    -------------------------------------------
    Carla Seyler
    Rehabilitation Counselor
    carla@seylerfavaloro.com
    New Orleans, LA United States
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  • 14.  RE: lcp summit

    Posted 05-07-2012 11:50
    Thanks Carla it was Harold that started the dialogue of how we as practitioners could support the Foundation and off it went with the numerous pledges and volunteers for the Foundation. Cloie Johnson, MEd cloie@osc-voc.com OSC Vocational Systems Inc 10132 NE 185th St Bothell, WA 98011 425-949-4406 direct dial 425-486-8701 fax Sent from my iPhone On May 7, 2012, at 8:43 AM, "Carla Seyler" wrote: > > Ditto in regard to Cloie's and everyone's involvement and hard work. I enjoyed being part of the process. > > Could someone clarify if it was the Academy or ICHCC that was requesting the donation for research? > > ------------------------------------------- > Carla Seyler > Rehabilitation Counselor > carla@seylerfavaloro.com > New Orleans, LA United States > ------------------------------------------- > > > > > > ------------------------------------------- > Original Message: > Sent: 05-07-2012 10:38 > From: Cloie Johnson > Subject: lcp summit > > We are working diligently to write up the proceedings - they will be > published in the (next hopefully) Journal of Life Care Planning and Nancy > Zangmeister and I will co-author a piece for the AANLCP Journal as well. > > I can not tell you how pleased I am with the efforts of so many who worked > so hard this weekend. The attendees spoke and the leadership listened. A > very encouraging weekend for sure for all life care planners. > > Best regards to all > > Cloie > > Cloie B. Johnson, MEd > cloie@osc-voc.com > OSC Vocational Systems Inc. > 10132 NE 185th St. > Bothell, WA 98011 > > 425-949-4406 direct dial > 425-486-8701 fax > > > Great news about the summit! When and how will the outcomes and > discussions be shared? > Thanks, > Arlette > > ------------------------------------------- > Arlette Loeser, OTR, ATP, CIE/P, CAPS, CDMS, CLCP > aloeser@advancedlcp.com > Avon, CT > New York, NY > ------------------------------------------- > > > > > > ------------------------------------------- > Original Message: > Sent: 05-07-2012 08:43 > From: Angela Heitzman > Subject: lcp summit > > Just returned from the Summit in Dallas and wanted to say Hats-off to > Cloie > Johnson and the rest of the Summit planning committee for such a > wonderful > summit! Consensus was reached on many items and LCP practice will be > better > for it. > > I am still flying high from the historic nature of the gathering-for > those > who were not able to attend, leaders from AANLCP, FLCPR, ICHCC, > IALCP/IARP > held a town hall meeting, and following the request of participants, met > to > see if any common ground could be found. The groups agreed to a dialogue > further to address commonalities and collaboration rather than the > divisiveness that has been present among the varying life care planning > groups for so long. Thanks to all who participated in this-Nancy > Zangmeister > and Joan Schofield from AANLCP, Susan Grisham and Chris Reid from FLCPR, > Sherry Latham and Evelyn Roberts from ICHCC, and Elizabeth Davis and > Steve > Yuhas from IALCP/IARP. > > I am so looking forward to the results of this collaboration. The > practice > of LCP will be stronger for it. > > Angie > > > > > > > > > > > > > > > > > >


  • 15.  RE:lcp summit

    Posted 05-07-2012 12:10
    Thanks to the over 35 attendees who pledged over $2,000 to the FLCPR this weekend!  I will be following up with each person who made a pledge to confirm their pledge and instructions on who and how to donate.  For those who are ready now, donations are accepted directly to the FLCPR website, via PayPal, at http://www.flcpr.org/donors_how_you_help.html.

    Many thanks to all for your generosity,

    Debbie
    -------------------------------------------
    Debra E. Berens, Ph.D.
    Rehab Consultant/Life Care Planner
    debra.berens@comcast.net
    Atlanta, GA United States
    -------------------------------------------








  • 16.  RE: lcp summit

    Posted 05-07-2012 10:42
    I echo Angie's comments. I compliment all of the members of the organizational committee, especially Cloie Johnson who did an outstanding job as chair of the summit. I also wish to thank all those from the organizations who participated in the Town Hall meeting; terrific and very valuable exchanges. The purpose of the Summit is for life cafe planners from all disciplines to reach consensus on items common to the practice of life care planning and in that regard, we were successful. When the results of the Summit are published in the Journal of Life Care Planning (as soon as possible, I hope), we will have documentation of these major consensus items that will only help us all in our practice. Thanks again to all in leadership and, of course, to the attendees who participated and made the Summit a success. Bob On Mon, May 7, 2012 at 7:12 AM, Angela Heitzman wrote: > > > Just returned from the Summit in Dallas and wanted to say Hats-off to Cloie > Johnson and the rest of the Summit planning committee for such a wonderful > summit! Consensus was reached on many items and LCP practice will be better > for it. > > I am still flying high from the historic nature of the gathering-for those > who were not able to attend, leaders from AANLCP, FLCPR, ICHCC, IALCP/IARP > held a town hall meeting, and following the request of participants, met to > see if any common ground could be found. The groups agreed to a dialogue > further to address commonalities and collaboration rather than the > divisiveness that has been present among the varying life care planning > groups for so long. Thanks to all who participated in this-Nancy > Zangmeister > and Joan Schofield from AANLCP, Susan Grisham and Chris Reid from FLCPR, > Sherry Latham and Evelyn Roberts from ICHCC, and Elizabeth Davis and Steve > Yuhas from IALCP/IARP. > > I am so looking forward to the results of this collaboration. The practice > of LCP will be stronger for it. > > Angie > > > >