Steroid injections for lower back pain have limited benefits, study says

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).

A new study points out that steroid shots temporarily alleviate lower back pain.

Chou said that lower back pain reduces and goes away with time without the requirement of treatment. But the benefits were not present with longer-term follow up.

You know how we once thought that steroid injections can relieve our lower back pain? Researcher have gone over 38 studies regarding cases of herniated disc, spinal stenosis and other conditions, analyzing the benefits of injections versus the placebo effect. Reviewing the evidence showed that the outcome was not influenced by the technique of injection or by the type of steroid administered. Long-term findings show that the effects of placebo and spinal injections were not far from each other and the need for surgery remained the same.

The steroid injections however bestowed patients with immediate pain relief and improved functioning of ruptured discs, but this was not so in the case of stenosis or spinal narrowing, the researchers wrote in Annals of Internal Medicine. Steroid injections also led to greater immediate functional improvement versus placebo (WMD -0.33; 95%CI -0.56 to -0.09).

Dr. Roger Chou, a medicine professor at Oregon Health & Science University, and a team of researchers reviewed 30 studies involving radiculopathy and eight trials involving spinal stenosis, and observed that within weeks of receiving epidural corticosteroid treatment, pain subsided and function was restored by a fractional amount, but that those results were null within three months’ time. Their pain relief was significant, but short lived. Fortunately, the latest study showed that the injections were not tied to major complications. Minor complications however included bleeding, blood clots and irritation of nerve root.

Epidural corticosteroid injections are among the most studied treatments in medical research, so previous reviews on their efficacy have varied, said Steven P. Cohen, a professor of anesthesiology and critical care medicine, and physical medicine and rehabilitation at Johns Hopkins University, who wasn’t involved in the study.

“The goal of epidural steroid injection is not for long term ‘cure, ‘ but rather to (improve) symptoms in order to allow restoration of sleep, quality of life, and tolerance of physical therapy”, McCormick said.

The question now stands as to why it would be worth offering the temporary option then, but patients are often frightened of surgery and might resort to any means to avoid it. However, they are advised not to fool themselves into thinking it’s a permanent solution to a common problem. “Otherwise, the costs and risks may outweigh the benefits”.