Chronic back pain: A society primed for pain with an emphasis on passive treatments

The article published on the July 31, 2018 issue of the New York Times science section, “After Doctors Cut Their Opioids, Patients Turn to a Risky Treatment for Back Pain” raises several thoughtful and concerning issues in pain management, including the lack of proven efficacy of spinal injections and the rising utilization of injections for the management of pain. In the interest of full disclosure, we are a group of Harvard spine and pain specialists from the department of Physical Medicine and Rehabilitation that emphasizes the importance of exercise, discourages opioid therapy for non-malignancy related pain, performs spinal injection procedures, and commonly practices non-FDA approved interventions. We take issue with several assumptions made by the author, as follows: