Steroid Injections Fail To Give Lasting Benefits In Lower Back Pain

Researchers have said that epidural steroid injections are quite frequently used for treating lower back pain that is related to herniated disk (when intervertebral disks compressed or bulges up) and to some extent spinal stenosis (narrowing of the spinal canal).

Chou said lower back pain usually improves over time without treatment, but some patients may want relief sooner. However, after that initial period, the steroid shots provided no significant advantage over placebos in terms of controlling pain intensity or increasing a patient’s ability to function.

However, there has been a degree of confusion regarding the beneficial effects of epidural corticosteroid injections, some claiming that there was no pain relief, whereas other stated that these steroid shots would be beneficial, all in all. Another noteworthy finding of the study was that neither the technique of injection performed nor the type of steroid administered appeared to matter.

But for the long run, epidural steroids injections had no better effects than a placebo, as researchers have noticed, and the patient’s need for surgery was not reduced at all. He pointed out that epidural corticosteroid treatments aren’t meant to be long-term solutions for radiculopathy and spinal stenosis, but rather temporary pain relievers patients can use while they heal. Spinal stenosis tends to be more degenerative than radiculopathy, and it is brought on by a narrowing of the open spaces within the spine, which puts pressure on the spinal cord and the nerves in the spine, arms and legs.

The injections are used to relieve pain from radiculopathy and spinal stenosis.

“We have known that steroid injections don’t have a lasting benefit”, said Shamie, who was not involved in the study. Injections aren’t risk-free either – complications with epidural steroid injections included blood clots, bleeding, and nerve root irritation.

They should understand that benefits are short-lived.

Dr. Chou regretted to inform that “there are not a lot of great treatments for these conditions besides surgery, so the options for treatment are limited”. “I do let patients know that the natural history for both of these conditions is for improvement over time”.

Not all experts in the field agree with the new analysis, and Dr. Zack McCormick from the Northwestern University Feinberg School of Medicine thinks that the recent findings are not applicable for real cases of spinal medicine. “More studies are needed which show outcomes of epidural steroid injections in conjunction with a multi-modal approach that includes physical therapy, oral medications, and other adjunctive treatments, as this represents true clinical practice”.

“Epidural steroid injections should not be used as an isolated therapy”, he added.

“Over a million people receive epidural injections either with steroids or with local anesthetic alone per year and at least 60% of them receive significant relief”, he said.