MONDAY, Jan. 12 (HealthDay News) -- Randomized controlled trials examining injection treatment for lower back pain show no beneficial effect and are often of poor quality, according to a review in the Jan. 1 issue of Spine.
J. Bart Staal, Ph.D., from Maastricht University in the Netherlands, and colleagues reviewed 18 randomized controlled trials including 1,179 patients that examined the effectiveness of injection therapy involving epidural sites and facet joints (such as intra-articular injections, peri-articular injections and nerve blocks) or local sites (such as tender and trigger points) for subacute or chronic lower back pain. Drugs included corticosteroids and local anesthetics.
The investigators found that only 10 of the trials were of high methodologic quality. Only six trials showed significant results for at least one outcome in favor of one treatment arm, and four of these trials showed effects of potential clinical importance. The trials were clinically heterogeneous and statistical pooling was not possible, the authors note.
"There is insufficient evidence to support the use of injection therapy in subacute and chronic low back pain," Staal and colleagues conclude. "However, it cannot be ruled out that specific subgroups of patients may respond to a specific type of injection therapy."
Abstract
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