Steroid injections probably won’t help your lower back pain

During the tests and experiments that the research team conducted, subjects who had ruptured discs experienced immediate pain relief and improved function after receiving spinal steroid injections.

“These injections may not be as effective as perceived”, said lead researcher Dr. Roger Chou from Oregon Science and Health University.

Lower back pain related to herniated disk (when intervertebral disks become compressed and bulge) and, to a lesser degree, spinal stenosis (narrowing of the spinal canal), is often treated with epidural steroid injections, the researchers said. So, people may still opt for steroid injections as pain relievers even though they are short-lived and the reduction of pain is relatively small.

Researchers have looked into 38 studies that have been published in the past although they didn’t find any kind of concrete evidence for supporting their use for these conditions.

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).

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”. However, subjects who had spinal narrowing did not experience these benefits. According to a report from Reuters, however, these injections offer no significant lasting relief from pinching around the spinal cord; a new study confirms that the pain relief is just temporary.

The procedure is also believed to reduce the need of undergoing disc surgery, but in the long run the shots were as efficient as a placebo in preventing these surgeries, researchers noted. But the benefits were not present with longer-term follow up.

Dr. Chou and his colleagues reached the same conclusions even after trying different steroid and different injection technique. Minor complications, on the other hand, were a little more common and included nerve root irritation, blood clots and bleeding.

Dr. Chou admitted that in these cases of spinal damage – fractured disc or stenosis – patients are left with a single option – disc surgery.

“Unfortunately, there are not a lot of great treatments for these conditions besides surgery, so the options for treatment are limited”, he added.

Chicago-based Dr. Zack McCormick, specialist in physical medicine and rehabilitation, said that Chou’s studies weren’t relevant.

The findings were published recently, in the journal Annals of Internal Medicine.

“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.