Con: I would not perform another ESI in this patient.

In a perfect world, this patient would receive an ESI, return to work, and stop her opioids. ESIs are relatively safe procedures, containing lower risks than opioid therapy [1,2]. However, the world we live in is not perfect, and the decisions we make need to consider factors such as perceptions from peers and patients, long-term financial implications, and unintended consequences. After weighing the potential risks and benefits in this patient, I would opt not to proceed with another ESI.