Pain medicine : the official journal of the American Academy of Pain Medicine
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Pain Med
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The aim of this study was to develop equations by which the costs could be compared of various models of performing diagnostic blocks for spinal pain. ⋯ Best practice, using placebo-controlled diagnostic blocks before neurosurgical therapy of zygapophysial joint pain, is not encouraged and rewarded in the United States. In Australia it is compensated only in the context of lumbar zygapophysial joint pain. In the interests of short-term financial savings, the US fee structure sacrifices the majority of patients to failed treatment because of lack of proper diagnosis. Clinical absurdity, rather than evidence-based, best practice is encouraged.