Epidural Steroid Injections for Back Pain Questioned

New guidelines suggest that injections provide no long-term relief from radicular lumbosacral pain

TUESDAY, March 6 (HealthDay News) -- Epidural injections of corticosteroids provide only limited short-term relief and do not provide long-term relief or help prevent surgery for patients with radicular lumbosacral pain, according to new American Academy of Neurology guidelines published in the March 6 issue of Neurology.

Carmel Armon, M.D., of the Bayside Medical Center in Springfield, Mass., and colleagues conducted Medline searches and looked for double-blind, placebo-controlled studies of epidural injections for radiculopathy. They found four studies that met their inclusion criteria.

The analysis suggests that two to six weeks after an epidural steroid injection, patients with radicular lumbosacral pain might show some improvement compared to control patients. However, the effect is relatively small and may not be generalizeable to all patients, given the small number of studies in a select group of patients. The injections do not improve function in those with average impairment, reduce the need for surgery or relieve pain beyond three months.

The Therapeutics and Technology Assessment Subcommittee concluded that "their routine use for these indications is not recommended" and that "there is insufficient evidence to make any recommendation for the use of epidural steroid injections to treat radicular cervical pain."

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