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It is never easy to change entrenched culture, she writes, “but the more the evidence fails to support the widespread use of these injections, the less inclined healthcare systems will be to fund them.” “This will not be the last word on spine injections for chronic back pain, but it adds to a growing sense that chronic pain management needs a major rethink that is perhaps best achieved by a better balance of reimbursements between procedural and non-procedural chronic pain treatments,” she concludes