By vgreene, 3 March, 2020 Not recommended Epidural injections not rec d for neurogenic claudication in central spinal canal stenosis 2
By vgreene, 3 March, 2020 Initiation of long term opioids rec d against by VA NICE 2 4 considered by ACP only as last resort if benefits risk after shared decision making 5
By vgreene, 3 March, 2020 Trials of not previously used neuropathic meds amitriptyline duloxetine gabapentin pregabalin rec d by NICE 3 nbsp nbsp Carefully evaluate pts for drug abuse hx before prescribing pregabalin or gabapentin watch for signs of abuse dependence 3 nbsp nbsp Pr
By vgreene, 3 March, 2020 Consider surg ref for sciatica when non surg tx not improving pain fxn and imaging consistent w pt sx 2
By vgreene, 3 March, 2020 Consider MRI if pain persists in spite of conservative tx 6wk per ACR 1 rec d against unless would affect tx per NICE2
By vgreene, 3 March, 2020 Not recommended acetaminophen PO corticosteroids BZD SSRI traction ultrasound TENS PENS acupuncture 1 2 4