NCPA - National Center for Policy Analysis


August 4, 2009

In England, 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.  Instead the National Institute of Health (NHW) and Clinical Excellence (NICE) is ordering doctors to offer patients remedies like acupuncture and osteopathy, says the Telegraph.

Every year, one-in-three people are estimated to suffer from lower back pain, while one in 15 consult their general practitioner (GP) about it.  Specialists say therapeutic injections using steroids can deaden nerve endings, can provide months or even years of respite from pain.  Others fear that if funding, tens of thousands of people, mainly the elderly and frail, will be left to suffer excruciating levels of pain or pay as much as £500 (about U.S. $847) each for private treatment, says the Telegraph:

  • The NHS currently issues more than 60,000 treatments of steroid injections every year.
  • NICE said in its guidance it wants to cut this to just 3,000 treatments a year, a move which would save the NHS £33 million (about U.S. $56 million).
  • But the British Pain Society, which represents specialists in the field, has written to NICE calling for the guidelines to be withdrawn after its members warned that they would lead to many patients having to undergo unnecessary and high-risk spinal surgery.

While the NICE guidelines admit that evidence was limited for many back pain treatments, where scientific proof was lacking, advice was instead taken from its expert group.

But specialists are furious that while the group included practitioners of alternative therapies, there was no one with expertise in conventional pain relief medicine to argue against a decision to significantly restrict its use, says the Telegraph.

Source: Laura Donnelly, "Patients forced to live in agony after NHS refuses to pay for painkilling injections," Telegraph, August 2, 2009.

For text:


Browse more articles on Health Issues