Anesthesiologists Say Not all Tests are Always Necessary

The American Society of Anesthesiologists, also known as the ASA, assert that patients who are suffering from chronic pain should question certain tests and treatments being put forth on them. Overall, the ASA claims that individuals who suffer chronic pain that is not related to cancer should not be required to undergo MRIs, X-rays and CT scans. These tests are commonly ordered but are not always necessary for such patients.

In addition, the ASA says that opioid analgesics should not be administered or prescribed to patients suffering from chronic pain that is not related to cancer. Instead, it asserts, doctors should consider a different type of treatment that does not involve drugs. These include behavioral and physical therapy that can be tried as alternatives prior to the use of pharmaceutical drugs. In the event that medication is recommended, the ASA recommends that non-opioids be used first.

In general, the ASA does not recommend prescribing opioid analgesics as a long term medication to treat chronic pain that is unrelated to cancer, at least until the risks are discussed with the patient. In addition, the patient should always be advised and informed of any and all risks of this type of treatment and the potential for developing an addiction as a result of taking these drugs. Doctors are always required to inform patients about any adverse side effects of low testosterone and estrogen or constipation.

The ASA also recommends that doctors avoid prescribing imaging studies on patients for acute low back pain unless they receive specific indications to do so. They should be avoided at least within the first six weeks after the patient’s pain starts unless there is a belief of cancer.

Intravenous sedation for a nerve block or joint injections is also advised against and should not be used as an automatic standard practice. The ASA states that such procedures as sedation should be done with anesthesia alone.

Irreversible interventions should also be avoided when dealing with patients experiencing non-cancer pain. These treatments include peripheral radiofrequency ablation and peripheral chemical neurolytic blocks, which can lead to long term weakness, numbness or increased pain in a patient that is irreversible.