Other hypotheses include steroids acting as ‘membrane stabilizers’ or acting as ‘thin-ners’ of connective tissue around painful nerve roots. A possible explanation for this lack of difference is that the main effect may be provided by the anesthetic which is thought to break the chronic pain cycle. Alternatively, the present study may not have had enough power to detect a difference that a larger study would have. The economic costs of arriving at the diagnosis of AWP are not trivial. flovent inhaler Similar to our findings, Hershfield found that 100 patients with chronic AWP underwent an average of 4.18 diagnostic tests which were purely exclusionary. The cost of working up AWP has been estimated in the past to be anywhere from US$680 to US$6,727. Our estimate of $764 is conservative in that it did not take into account visits to other specialists such as gynecologists, general surgeons and urologists, visits to the emergency department and hospital admissions. Hence, the actual total cost is far greater.

In summary, our study demonstrates that TPI, in patients who meet the criteria for AWP, are effective over the long term.