More than 30 pain medicine societies are calling on The BMJ to retract a clinical practice guideline that advises against interventional procedures for chronic spine pain.

The guideline, part of the BMJ Rapid Recommendations series, recommends that procedures such as epidural injections of anaesthetic or steroids should not be offered to adults with chronic axial or radicular spine pain that is not associated with cancer or inflammatory arthropathy, outside of clinical trials.

It was based on a network meta-analysis, published in the same journal, which evaluated 81 trials covering nearly 8000 patients.

“Our network meta-analysis of randomised trials provides low to moderate certainty evidence that, compared with sham procedures, commonly performed interventional procedures for axial or radicular chronic non-cancer spine pain may provide little to no pain relief,” the authors concluded.