Last week, the national television personality Dr. Mehmet Oz aired a segment on a common chronic pain treatment procedure called epidural steroid injections. While I have a great deal of respect for the depth and thoughtfulness of Dr. Oz’s work, this segment provided a disservice to viewers by drastically misrepresenting what most board certified physicians and leading researchers consider a safe, effective and important treatment for patients with chronic back pain.
While some of Dr. Oz’s concerns were valid, many were over-dramatized to the point of being deliberately misleading. His investigative reporter used a series of sound bites and alarming statistics that were clearly meant to frighten viewers. Certainly every procedure has risks, but to lead the show with such an inflammatory, overhyped report greatly overshadowed any “pros and cons” discussion that could follow.
For many patients with conditions like sciatica or radiculopathy, an ESI is often the only treatment option that lets them resume normal activities. Without an ESI, these patients would be left with a life of pain and immobility. In some cases, surgery can be delayed or even avoided when a board-certified practitioner treats a patient with an ESI. Additionally, many studies concerning ESIs are outdated and do not consider important parts of the procedure that are standard today, such as fluoroscopy and X-ray guidance tools, which significantly lower the risks. In fact, a 2013 study conducted by leading researchers from Harvard, Johns Hopkins and Walter Reed Medical Center found that complications are rare following ESIs, provided proper precautions are taken. I have discussed this research at length – as well as the correct indications and safety for epidural injections – in lectures at both the Mayo Clinic and Cleveland Clinic earlier this year.
In short, viewers of the Dr. Oz show segment came away with a distorted and overly negative impression of ESIs. I do agree that epidural steroid injections should be done only by board certified, fellowship trained physicians. However, I am more worried that some of the alternatives for treating chronic pain have even more potential negative side effects than an ESI. From a professional standpoint, it is hard to accept how many Americans become addicted to opioid pain killers. Believe it or not, they cause more overdose deaths in the United States every year than heroin, crack cocaine and methamphetamines combined. Dr. Oz’s presentation of the ESI discussion may drive thousands more to insist on opioid-based treatment rather than even considering treatment with an ESI.
This topic deserves a more balanced dialogue than The Dr. Oz Show presented. Despite comments by a pro-ESI doctor toward the end, the segment was defined by its dramatically negative opening, which categorized practices using the procedure as profit-driven “injection mills.” Again, I recognize and applaud the valuable service Dr. Oz provides millions of health-conscious Americans, but in this case the hype overwhelmed the reality.
Dr. Nilesh Patel
Advanced Pain Management