Lower Back Pain Temporarily Treated With Steroid

According to a new study, steroid injection or spinal epidural injections may offer relief from lower back pain due to a ruptured disc but the relief could be brief and not lasting. However, a worrying fact is that those treated with placebo did not fare any worse, so it eliminates the benefits of the medication and no longer supports their recommendation from medical health professionals. These trials that are performed in random order delved into the effects of spinal corticosteroid injections compared to placebo, techniques and overall corticosteroid use.

Other studies have shown the benefit of spinal injections, but enough have reached similar conclusions to say that an injection of steroids does little to address the underlying cause of the pain.

The injection technique employed or the specific steroid chosen also did not appear to matter.

Injections also seemed to reduce the need for disc surgery in the short term.

Patients with spinal stenosis, on the other hand, saw absolutely no improvement of injections in comparison to the placebo. Steroid injections also led to greater immediate functional improvement versus placebo (WMD -0.33; 95%CI -0.56 to -0.09).

Dr. Chou gave a statement to Reuters Health saying that “I think the important thing is for patients and clinicians to be able to make informed decisions”.

The good news, however, is that the study did not find the injections to have any negative impact; apart from rare blood clots, small bleeding events, and sometimes nerve soreness, the patient’s situation did not worsen.

Specifically, the researchers looked at how epidural corticosteroid injections impacted patients’ pain, function and risk for surgery. Chou’s team evaluated the treatment’s impact on future surgery risk and pain on a 0 to 100 scale, while they used a standardized mean difference for function because studies’ scales differed between 0 to 24 and 0 to 100.

Herniated disk and spinal stenosis each account for about 3 percent to 4 percent of patients with lower back pain, the researchers said in background notes.

The conclusions that the study eventually derives to, were of low quality and thus can not be used for realistic daily practice of spine medicine, highlights another specialist of the field Dr. Zack McCormick, physical medicine and rehabilitation specialist from the Northwestern University Feinberg School of Medicine.

The study suggests that one of the most common treatments for back pain, epidural steroid injections, is ineffective at treating the root cause of discomfort in many cases.

He noted, however, that the aim of epidural corticosteroid injections is to improve short-term symptoms and quality of life for the patient, not to provide a long-term cure.

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.