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All steroid injections (usually combined with Local anaesthetic agents) are palliative, short lasting and should be spaced by few months at least to minimise their side effects. Physiotherapy should be in the form of active back exercises to strengthen the muscles and reduce the joint stiffness not the passive message. The Pain Specialist are the appropriate expert to be consulted when surgical treatment has been ruled out by the spinal surgeon.

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Mr. Ameen Abbas Ameen

Medico Legal Expert, Neurosurgeon

London

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