American Academy of Physical Medicine and Rehabilitation

View all recommendations from this society

September 29, 2014

Don’t order repeat epidural steroid injections without evaluating the individual’s response to previous injections.

Utilization of repeat epidural steroid injections has not been shown to improve patient outcomes. Physicians should consider patient re-evaluation prior to repeat epidural steroid injections.


These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.

How The List Was Created

The American Academy of Physical Medicine and Rehabilitation (AAPM&R) established a Choosing Wisely® task force to develop its list of recommendations. To ensure broad representation across our diverse specialty, members of this group were selected from varying practice settings and subspecialties within physical medicine & rehabilitation. The task force developed a list of topics they felt had the most impact on the field, which were then rated based upon their relevancy to the Choosing Wisely® campaign. Based on the task force ratings and a literature review, candidate recommendations were sent to relevant AAPM&R committees, councils and subject matter experts for review and comment. The task force reviewed this feedback and voted on the final “Top Five” recommendations, which were approved by the Evidence Based Practice Committee; Quality, Practice, Policy and Research Committee; and the Board of Governors.

AAPM&R’s disclosure and conflict of interest statements can be found at www.aapmr.org.

Sources

Novak S, Nemeth WC. The basis for recommending repeating epidural steroid injections for radicular low back pain: a literature review. Arch Phys Med Rehabil. 2008 Mar;89:543–52.