UK: Patients forced to live in agony

[ozzmdj]

UK: Patients forced to live in agony after NHS refuses to pay for painkilling injections... Patients forced to live in agony after NHS refuses to pay for painkilling injections - Telegraph

 

[Dr Grump]

You are such a Troll....

 

[WillowTree]

You are such a Troll....

Isn't the Telegraph a respected newspaper?

 

[Emma]

The Government's drug rationing watchdog says "therapeutic" injections of steroids, such as cortisone, which are used to reduce inflammation, should no longer be offered to patients suffering from persistent lower back pain when the cause is not known.

A spokesman for NICE said its guidance did not recommend that injections were stopped for all patients, but only for those who had been in pain for less than a year, where the cause was not known.

In response, NICE chairman Professor Sir Michael Rawlins expressed outrage over the vote that forced Dr Watson from his position, describing the actions of the society as "shameful". He accused pain specialists of refusing to accept that there was insufficient scientific evidence to support their practices.

----------

Now, I'd have to go on a search for trials to find out what he's talking about BUT even without doing that, the restriction on steroid injections where the cause is unknown makes perfect sense. While complications may be uncommon, they're not unheard of and some are pretty significant. I certainly wouldn't want my doc doing such an invasive procedure without knowing the cause of my pain. Pain is the body's way of telling you something is wrong. To simply mask the pain without knowing why it's there is stupid.

 

[WillowTree]

The Government's drug rationing watchdog says "therapeutic" injections of steroids, such as cortisone, which are used to reduce inflammation, should no longer be offered to patients suffering from persistent lower back pain when the cause is not known.

A spokesman for NICE said its guidance did not recommend that injections were stopped for all patients, but only for those who had been in pain for less than a year, where the cause was not known.

In response, NICE chairman Professor Sir Michael Rawlins expressed outrage over the vote that forced Dr Watson from his position, describing the actions of the society as "shameful". He accused pain specialists of refusing to accept that there was insufficient scientific evidence to support their practices.

----------

Now, I'd have to go on a search for trials to find out what he's talking about BUT even without doing that, the restriction on steroid injections where the cause is unknown makes perfect sense. While complications may be uncommon, they're not unheard of and some are pretty significant. I certainly wouldn't want my doc doing such an invasive procedure without knowing the cause of my pain. Pain is the body's way of telling you something is wrong. To simply mask the pain without knowing why it's there is stupid.

Unreasonable,, many many many cases of back pain have unknown causes and are chronic,, so to expect someone to be in pain for a year and for the Dr. to "find a cause" is unreasonable.. you try being in pain for 365 days and see how reasonable that seems to you.

 

[Emma]

The Government's drug rationing watchdog says "therapeutic" injections of steroids, such as cortisone, which are used to reduce inflammation, should no longer be offered to patients suffering from persistent lower back pain when the cause is not known.

A spokesman for NICE said its guidance did not recommend that injections were stopped for all patients, but only for those who had been in pain for less than a year, where the cause was not known.

In response, NICE chairman Professor Sir Michael Rawlins expressed outrage over the vote that forced Dr Watson from his position, describing the actions of the society as "shameful". He accused pain specialists of refusing to accept that there was insufficient scientific evidence to support their practices.

----------

Now, I'd have to go on a search for trials to find out what he's talking about BUT even without doing that, the restriction on steroid injections where the cause is unknown makes perfect sense. While complications may be uncommon, they're not unheard of and some are pretty significant. I certainly wouldn't want my doc doing such an invasive procedure without knowing the cause of my pain. Pain is the body's way of telling you something is wrong. To simply mask the pain without knowing why it's there is stupid.

Unreasonable,, many many many cases of back pain have unknown causes and are chronic,, so to expect someone to be in pain for a year and for the Dr. to "find a cause" is unreasonable.. you try being in pain for 365 days and see how reasonable that seems to you.

I AM. I have chronic back pain, thanks to lifting and tugging on patients for 25 years.

They aren't saying you have to be in pain for a year before you can receive steroid injections. They are refusing it when the cause is unknown.

Tests can show radiculopathy and other conditions that steroids WILL help. The docs can also do tests to rule out more serious reasons for back pain. Once that is done, if they have a condition that steroids will help, then they can have the injections.

I've known of people who've received steroids for pain, only to be masking a more serious condition. Any doc who would just shoot you up without first attempting to diagnose the problem is an idiot, and dangerous IMO.

What they are proposing makes perfect sense.

Even private insurance here have similar rules regarding the use of steroids.

MEDICAL APPROPRIATENESS

Lumbar epidural steroid injections for the treatment of acute and chronic low back pain is considered medically appropriate if ALL of the following criteria are met:

• When performed under fluoroscopy
  
  
• There is documentation of radiculopathy (by exam, imaging, or neuro-testing) which is unresponsive to conservative treatment (e.g., oral medications, rest/limited activity, and/or physical therapy)

ABSENCE of ALL of the following:

• Allergy to the medication to be administered
  
  
• A significantly altered or eliminated epidural space (e.g., congenital anatomic anomalies or previous surgery)
  
  
• Anticoagulation therapy
  
  
• Bleeding disorder
  
  
• Clinically significant spinal stenosis
  
  
• Localized infection in the region to be injected
  
  
• Systemic infection
  
  
• Other co-morbidities which could be exacerbated by steroid usage (e.g., poorly controlled hypertension, severe congestive heart failure, diabetes, etc.)
  
  
• More than 3 (three) epidural steroid injections have been given without significant relief of low back pain over a reasonable length of time

Lumbar Epidural Steroid Injections for Treatment of Low Back Pain

In other words, AFTER diagnostics prove that a condition exists where steroids will be effective, and rule out other conditions/contraindications.

 

[WillowTree]

The Government's drug rationing watchdog says "therapeutic" injections of steroids, such as cortisone, which are used to reduce inflammation, should no longer be offered to patients suffering from persistent lower back pain when the cause is not known.

A spokesman for NICE said its guidance did not recommend that injections were stopped for all patients, but only for those who had been in pain for less than a year, where the cause was not known.

In response, NICE chairman Professor Sir Michael Rawlins expressed outrage over the vote that forced Dr Watson from his position, describing the actions of the society as "shameful". He accused pain specialists of refusing to accept that there was insufficient scientific evidence to support their practices.

----------

Now, I'd have to go on a search for trials to find out what he's talking about BUT even without doing that, the restriction on steroid injections where the cause is unknown makes perfect sense. While complications may be uncommon, they're not unheard of and some are pretty significant. I certainly wouldn't want my doc doing such an invasive procedure without knowing the cause of my pain. Pain is the body's way of telling you something is wrong. To simply mask the pain without knowing why it's there is stupid.

Unreasonable,, many many many cases of back pain have unknown causes and are chronic,, so to expect someone to be in pain for a year and for the Dr. to "find a cause" is unreasonable.. you try being in pain for 365 days and see how reasonable that seems to you.

I AM. I have chronic back pain, thanks to lifting and tugging on patients for 25 years.

They aren't saying you have to be in pain for a year before you can receive steroid injections. They are refusing it when the cause is unknown.

Tests can show radiculopathy and other conditions that steroids WILL help. The docs can also do tests to rule out more serious reasons for back pain. Once that is done, if they have a condition that steroids will help, then they can have the injections.

I've known of people who've received steroids for pain, only to be masking a more serious condition. Any doc who would just shoot you up without first attempting to diagnose the problem is an idiot, and dangerous IMO.

What they are proposing makes perfect sense.

Even private insurance here have similar rules regarding the use of steroids.

MEDICAL APPROPRIATENESS

Lumbar epidural steroid injections for the treatment of acute and chronic low back pain is considered medically appropriate if ALL of the following criteria are met:

• When performed under fluoroscopy
  
  
• There is documentation of radiculopathy (by exam, imaging, or neuro-testing) which is unresponsive to conservative treatment (e.g., oral medications, rest/limited activity, and/or physical therapy)

ABSENCE of ALL of the following:

• Allergy to the medication to be administered
  
  
• A significantly altered or eliminated epidural space (e.g., congenital anatomic anomalies or previous surgery)
  
  
• Anticoagulation therapy
  
  
• Bleeding disorder
  
  
• Clinically significant spinal stenosis
  
  
• Localized infection in the region to be injected
  
  
• Systemic infection
  
  
• Other co-morbidities which could be exacerbated by steroid usage (e.g., poorly controlled hypertension, severe congestive heart failure, diabetes, etc.)
  
  
• More than 3 (three) epidural steroid injections have been given without significant relief of low back pain over a reasonable length of time

Lumbar Epidural Steroid Injections for Treatment of Low Back Pain

In other words, AFTER diagnostics prove that a condition exists where steroids will be effective, and rule out other conditions/contraindications.

steroids are given to reduce the inflammation. yes?

 

[WillowTree]

The Government's drug rationing watchdog says "therapeutic" injections of steroids, such as cortisone, which are used to reduce inflammation, should no longer be offered to patients suffering from persistent lower back pain when the cause is not known.

A spokesman for NICE said its guidance did not recommend that injections were stopped for all patients, but only for those who had been in pain for less than a year, where the cause was not known.

In response, NICE chairman Professor Sir Michael Rawlins expressed outrage over the vote that forced Dr Watson from his position, describing the actions of the society as "shameful". He accused pain specialists of refusing to accept that there was insufficient scientific evidence to support their practices.

----------

Now, I'd have to go on a search for trials to find out what he's talking about BUT even without doing that, the restriction on steroid injections where the cause is unknown makes perfect sense. While complications may be uncommon, they're not unheard of and some are pretty significant. I certainly wouldn't want my doc doing such an invasive procedure without knowing the cause of my pain. Pain is the body's way of telling you something is wrong. To simply mask the pain without knowing why it's there is stupid.

Unreasonable,, many many many cases of back pain have unknown causes and are chronic,, so to expect someone to be in pain for a year and for the Dr. to "find a cause" is unreasonable.. you try being in pain for 365 days and see how reasonable that seems to you.

I AM. I have chronic back pain, thanks to lifting and tugging on patients for 25 years.

They aren't saying you have to be in pain for a year before you can receive steroid injections. They are refusing it when the cause is unknown.

Tests can show radiculopathy and other conditions that steroids WILL help. The docs can also do tests to rule out more serious reasons for back pain. Once that is done, if they have a condition that steroids will help, then they can have the injections.

I've known of people who've received steroids for pain, only to be masking a more serious condition. Any doc who would just shoot you up without first attempting to diagnose the problem is an idiot, and dangerous IMO.

What they are proposing makes perfect sense.

Even private insurance here have similar rules regarding the use of steroids.

MEDICAL APPROPRIATENESS

Lumbar epidural steroid injections for the treatment of acute and chronic low back pain is considered medically appropriate if ALL of the following criteria are met:

• When performed under fluoroscopy
  
  
• There is documentation of radiculopathy (by exam, imaging, or neuro-testing) which is unresponsive to conservative treatment (e.g., oral medications, rest/limited activity, and/or physical therapy)

ABSENCE of ALL of the following:

• Allergy to the medication to be administered
  
  
• A significantly altered or eliminated epidural space (e.g., congenital anatomic anomalies or previous surgery)
  
  
• Anticoagulation therapy
  
  
• Bleeding disorder
  
  
• Clinically significant spinal stenosis
  
  
• Localized infection in the region to be injected
  
  
• Systemic infection
  
  
• Other co-morbidities which could be exacerbated by steroid usage (e.g., poorly controlled hypertension, severe congestive heart failure, diabetes, etc.)
  
  
• More than 3 (three) epidural steroid injections have been given without significant relief of low back pain over a reasonable length of time

Lumbar Epidural Steroid Injections for Treatment of Low Back Pain

In other words, AFTER diagnostics prove that a condition exists where steroids will be effective, and rule out other conditions/contraindications.

which could mean months and years under government run health care, years of pain and misery.so what the article says is true.

 

[Emma]

Unreasonable,, many many many cases of back pain have unknown causes and are chronic,, so to expect someone to be in pain for a year and for the Dr. to "find a cause" is unreasonable.. you try being in pain for 365 days and see how reasonable that seems to you.

I AM. I have chronic back pain, thanks to lifting and tugging on patients for 25 years.

They aren't saying you have to be in pain for a year before you can receive steroid injections. They are refusing it when the cause is unknown.

Tests can show radiculopathy and other conditions that steroids WILL help. The docs can also do tests to rule out more serious reasons for back pain. Once that is done, if they have a condition that steroids will help, then they can have the injections.

I've known of people who've received steroids for pain, only to be masking a more serious condition. Any doc who would just shoot you up without first attempting to diagnose the problem is an idiot, and dangerous IMO.

What they are proposing makes perfect sense.

Even private insurance here have similar rules regarding the use of steroids.

MEDICAL APPROPRIATENESS

Lumbar epidural steroid injections for the treatment of acute and chronic low back pain is considered medically appropriate if ALL of the following criteria are met:

• When performed under fluoroscopy
  
  
• There is documentation of radiculopathy (by exam, imaging, or neuro-testing) which is unresponsive to conservative treatment (e.g., oral medications, rest/limited activity, and/or physical therapy)

ABSENCE of ALL of the following:

• Allergy to the medication to be administered
  
  
• A significantly altered or eliminated epidural space (e.g., congenital anatomic anomalies or previous surgery)
  
  
• Anticoagulation therapy
  
  
• Bleeding disorder
  
  
• Clinically significant spinal stenosis
  
  
• Localized infection in the region to be injected
  
  
• Systemic infection
  
  
• Other co-morbidities which could be exacerbated by steroid usage (e.g., poorly controlled hypertension, severe congestive heart failure, diabetes, etc.)
  
  
• More than 3 (three) epidural steroid injections have been given without significant relief of low back pain over a reasonable length of time

Lumbar Epidural Steroid Injections for Treatment of Low Back Pain

In other words, AFTER diagnostics prove that a condition exists where steroids will be effective, and rule out other conditions/contraindications.

which could mean months and years under government run health care, years of pain and misery.so what the article says is true.

No.

 

[WillowTree]

yes,

 

[Wry Catcher]

I suggest anyone interested in how UK subjects view their NHS visit a message board in the UK. I have and asked those who live in the UK how they feel about the NHS. The responses were 100% in support. Of course there were and are problems, but each response I received supported their system and condemned our profit driven system.

 

[geauxtohell]

The Government's drug rationing watchdog says "therapeutic" injections of steroids, such as cortisone, which are used to reduce inflammation, should no longer be offered to patients suffering from persistent lower back pain when the cause is not known.

A spokesman for NICE said its guidance did not recommend that injections were stopped for all patients, but only for those who had been in pain for less than a year, where the cause was not known.

In response, NICE chairman Professor Sir Michael Rawlins expressed outrage over the vote that forced Dr Watson from his position, describing the actions of the society as "shameful". He accused pain specialists of refusing to accept that there was insufficient scientific evidence to support their practices.

----------

Now, I'd have to go on a search for trials to find out what he's talking about BUT even without doing that, the restriction on steroid injections where the cause is unknown makes perfect sense. While complications may be uncommon, they're not unheard of and some are pretty significant. I certainly wouldn't want my doc doing such an invasive procedure without knowing the cause of my pain. Pain is the body's way of telling you something is wrong. To simply mask the pain without knowing why it's there is stupid.

Sounds like another case of good medicine that is shamelessly being distorted and pimped to scare people about socialized medicine.

IMO, too often "chronic pain" is continually treated without trying to correct the underlying condition. If the condition is something like SCA, then you can't do anything for it other than provide narcs. However, if it's back pain, too often patients just want a pain pill and refuse physical therapy. Again, IMO, it just becomes an outlet for people who have inadvertantly become addicted to opiates to get their fix. They might not even have real pain. The pain they expericence is from opium withdrawal.

For this, I've never heard of any doctor injecting steroids into someone's back for pain management of an unknown etiology. That would bother me quite a bit.

 

[Emma]

The Government's drug rationing watchdog says "therapeutic" injections of steroids, such as cortisone, which are used to reduce inflammation, should no longer be offered to patients suffering from persistent lower back pain when the cause is not known.

A spokesman for NICE said its guidance did not recommend that injections were stopped for all patients, but only for those who had been in pain for less than a year, where the cause was not known.

In response, NICE chairman Professor Sir Michael Rawlins expressed outrage over the vote that forced Dr Watson from his position, describing the actions of the society as "shameful". He accused pain specialists of refusing to accept that there was insufficient scientific evidence to support their practices.

----------

Now, I'd have to go on a search for trials to find out what he's talking about BUT even without doing that, the restriction on steroid injections where the cause is unknown makes perfect sense. While complications may be uncommon, they're not unheard of and some are pretty significant. I certainly wouldn't want my doc doing such an invasive procedure without knowing the cause of my pain. Pain is the body's way of telling you something is wrong. To simply mask the pain without knowing why it's there is stupid.

Sounds like another case of good medicine that is shamelessly being distorted and pimped to scare people about socialized medicine.

IMO, too often "chronic pain" is continually treated without trying to correct the underlying condition. If the condition is something like SCA, then you can't do anything for it other than provide narcs. However, if it's back pain, too often patients just want a pain pill and refuse physical therapy. Again, IMO, it just becomes an outlet for people who have inadvertantly become addicted to opiates to get their fix. They might not even have real pain. The pain they expericence is from opium withdrawal.

For this, I've never heard of any doctor injecting steroids into someone's back for pain management of an unknown etiology. That would bother me quite a bit.

I'm fading fast here, so I'm hoping this makes sense ...

No doc worth a damn is going to prescribe a treatment without first knowing what he's treating and that the treatment prescribed is appropriate for the condition. And certainly not one that is invasive and carries the risk of complications and side effects such as this.

Bottom line, it plainly states "when the cause is not known". That is completely reasonable and good practice.

 

[geauxtohell]

I'm fading fast here, so I'm hoping this makes sense ...

No doc worth a damn is going to prescribe a treatment without first knowing what he's treating and that the treatment prescribed is appropriate for the condition. And certainly not one that is invasive and carries the risk of complications and side effects such as this.

Bottom line, it plainly states "when the cause is not known". That is completely reasonable and good practice.

Me too, though my experience is miniscule. I guess in ambulatory clinic I am used to seeing it from the less invasive narcotic Rx side, but dealing with chronic pain for people who only want pain meds for a condition that can be treated by giving out narcotic scripts isn't in anyone's best interest.

Get some sleep.

 

[Emma]

I suggest anyone interested in how UK subjects view their NHS visit a message board in the UK. I have and asked those who live in the UK how they feel about the NHS. The responses were 100% in support. Of course there were and are problems, but each response I received supported their system and condemned our profit driven system.

My daughter lived in England for 6 months, and unfortunately found out first-hand how good their system really is. Her 2 year old caught his finger in a door and nearly severed it (her description left me rather woozy lol). He was not only immediately seen by a pediatric plastics specialist, but his work was so good you really can't tell he'd ever been injured so badly. They followed up with home visits to monitor his progress for some time after. She had other occasions to use their services while there and had nothing but good to say about the care they all received.

 

[Emma]

I'm fading fast here, so I'm hoping this makes sense ...

No doc worth a damn is going to prescribe a treatment without first knowing what he's treating and that the treatment prescribed is appropriate for the condition. And certainly not one that is invasive and carries the risk of complications and side effects such as this.

Bottom line, it plainly states "when the cause is not known". That is completely reasonable and good practice.

Me too, though my experience is miniscule. I guess in ambulatory clinic I am used to seeing it from the less invasive narcotic Rx side, but dealing with chronic pain for people who only want pain meds for a condition that can be treated by giving out narcotic scripts isn't in anyone's best interest.

Get some sleep.

lol

I will try.

 

[xsited1]

UK: Patients forced to live in agony after NHS refuses to pay for painkilling injections... Patients forced to live in agony after NHS refuses to pay for painkilling injections - Telegraph

Check this out.

A 15,000-signature petition demanding the screening age for cervical cancer in England be cut from 25 to 18 is due to be delivered to Downing Street.

...

BBC NEWS | UK | England | London | Petition urges smear test age cut

 

[Life_Long_Dem!]

of course the focus here in the op is to push the negative aspects of uhc in other nations...ram it down our throats and say "see how bad it is!" when in reality there is good and bad in all things but let us see here.......France...socialist healthcare that works well along side private insurance...Norway...socialist healthcare that everyone INCLUDING non socialist like, higher rate of healthy people at a third of the cost of Us profit driven system, Canada...I have seen comment after comment after comment from Canadians that like the system they have.

The bottom line is The US profit....stockholder driven market fears now and has always feared competition and stops at NOTHING to put fear into the American people about accepting anything else but what we have now.

 

[Emma]

UK: Patients forced to live in agony after NHS refuses to pay for painkilling injections... Patients forced to live in agony after NHS refuses to pay for painkilling injections - Telegraph

Check this out.

A 15,000-signature petition demanding the screening age for cervical cancer in England be cut from 25 to 18 is due to be delivered to Downing Street.

...

BBC NEWS | UK | England | London | Petition urges smear test age cut

Screening for Cervical Cancer: Recommendations and Rationale

 

[xsited1]

UK: Patients forced to live in agony after NHS refuses to pay for painkilling injections... Patients forced to live in agony after NHS refuses to pay for painkilling injections - Telegraph

Check this out.

A 15,000-signature petition demanding the screening age for cervical cancer in England be cut from 25 to 18 is due to be delivered to Downing Street.

...

BBC NEWS | UK | England | London | Petition urges smear test age cut

Screening for Cervical Cancer: Recommendations and Rationale

Good information. From your link:

Indirect evidence suggests most of the benefit can be obtained by beginning screening within 3 years of onset of sexual activity or age 21 (whichever comes first) and screening at least every 3 years

I wonder why the UK would restrict it to 25 years and above? Now the citizens have to sign a petition to get the government to provide for this.