With this, the researchers of the new study reviewed evidences that pertain to the positive and negative effects of spinal steroid injections in adult patients, who were diagnosed with variable duration spinal stenosis/ narrowing and radicular low back pain. The researchers add further that the injections do not offer any significant relief from paint on account of narrowing of space around the spinal cord. But the benefits were no longer present with longer-term follow-up.
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Usually steroid injections are given to treat herniated disk related back pain, which means when the intervertebral disks is bulged and compressed.
Some earlier studies have reached similar conclusions, but others have shown some benefit.
These findings remained regardless of what injection techniques and corticosteroids were used, according to the authors.
For patients with radiculopathy or spinal stenosis, epidural corticosteroid injections are unlikely to provide effective pain relief, according to the study.
“These injections may not be as effective as perceived”, said lead researcher Dr. Roger Chou from Oregon Science and Health University.
The study however did not find any serious complications arising from the injections. “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”. The results demonstrated that steroid injections are associated with only short-term improvement in pain intensity and function versus placebo for the treatment of radiculopathy, with no long-term benefits. “When you offer a procedure to patients that doesn’t have a lasting benefit and ultimately they may need a definitive treatment”, he said, “the question is, should we keep offering them this shorter-lived treatment?” Injections aren’t risk-free either – complications with epidural steroid injections included blood clots, bleeding, and nerve root irritation.
“Unfortunately, there are not a lot of great treatments for these conditions besides surgery, so the options for treatment are limited”, he added.
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. The randomized trials delved into the effects of spinal corticosteroid injections compared to placebo, techniques and overall corticosteroid use. As such, he says the treatment should “not be used as an isolated therapy”.
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“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.
