Issue: BCMJ, Vol. 53,
page(s) 66 Letters
Hugh H. Macartney, MB, FRCP
The [WorkSafeBC] article “Evidence-based treatment of chronic pain” purports to provide an unlimited review of the subject [BCMJ 2010;52:515-516]. As a retired anesthesiologist with many years’ experience in pain clinic work, I am very surprised that the practice group that conducted the review appears to be unaware of the valuable role played by a wide range of nerve blocks and allied modalities in diagnosis and treatment of chronic pain.
Reflex sympathetic dystrophy forms a significant part of the pain spectrum, and early sympathetic blocks can prevent the condition from becoming chronically intractable. No mention is made of the valuable part that steroid injections play in pain management, nor is there a single reference to the role of professional pain clinics, both in hospital and freestanding.
The authors appear to be unaware that there are medical journals that deal specifically with pain and its management and that provide the evidence of current professional research. Lastly, the website quoted for the full review does not appear to be available. I would give this article a failing grade.
—Hugh H. Macartney, MB