Steroid Injections have short term impact in Lower Back pain treatment

Epidural steroid injections are not very effective in treating low back pain, a new research suggests. He advised spine practitioners to prescribe them only if the first-line treatment for low back pain, which usually consists of therapy and over-the-counter painkillers, don’t work. 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.

For their research, Chou and his team picked 38 placebo-controlled studies from a pool of about 50, and analyzed the ability of epidural corticosteroid injections to restore function, and reduce pain and the need for surgery within a few weeks and a few months.

Past studies had shown similar results but doctors continue to recommend them as treatment for low back pain caused by broken disks or the narrowing of spaces between the bones of the spine (also known as stenosis).

Spinal steroid injections brought immediate relief of pain and improvement in function in patients with ruptured discs, but not in patients with spinal narrowing, or stenosis, the researchers reported in Annals of Internal Medicine.

According to Dr. Roger Chou from Oregon Health and Science University in Portland, “I think the important thing is for patients and clinicians to be able to make informed decisions”. Each year, more than a million people are administered epidural injections either with local anesthetic or steroids, and so far, their benefits are still outweighing the risks. Fortunately, the latest study showed that the injections were not tied to major complications. They aren’t without their risks either – some minor complications included blood clots, bleeding, and nerve root irritation. Thus, stenosis is the pathological term used to explain the narrowing of a bodily canal, in this case the constriction of the spinal cord.

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”. Chou added further that he does let patients be aware that natural history in both the conditions was only improvement over time.

Dr. Zack McCormick, physical medicine and rehabilitation specialist from Northwestern University’s Feinberg School of Medicine (Chicago), gave a statement to Reuters Health saying that the studies Dr. Chou and his colleagues looked at had a low quality, which means that their conclusions can not be taken seriously in day to day practice.

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.

It’s a common problem that most would do anything to be rid of, but steroids might not help your back pain and their effects might just be temporary.

But Shamie said that patients often want to try a steroid injection because they fear surgery.