PCA Deep Dive: When the Evidence Changes, Rethinking Spine Injections for Chronic Pain

The Spinal Chat Podcast: PCA Deep Dive Series examines 2025 BMJ evidence on routine interventional procedures for chronic non-cancer spine pain and asks: When the evidence changes, should the way we deliver and pay for care change with it?

A major BMJ systematic review and network meta-analysis included 132 eligible studies, with 81 randomized trials and 7,977 patients contributing to the quantitative analysis. It found that commonly used interventional procedures generally produced little to no clinically meaningful pain relief compared with sham procedures for chronic axial or radicular spine pain. A companion guideline issued strong recommendations against routine use, while int ...