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A new study has found that lower back pain can be temporarily treated with steroid injections to the spine if you have a ruptured disc.
Unfortunately the results aren’t very promising as the injections only provide patients who have spinal narrowing (stenosis) with slight pain relief, nothing significant.
The issue is constantly being debated as some previous studies have suggested the same things, while others have suggested that the treatments offers real benefits.
This uncertainty has caused doctors to use epidural steroid injections more and more in recent years. And oddly enough, they have not been able to reach a definitive conclusion by talking to their patients.
Dr. Roger Chou, field expert from Oregon Health & Science University (Portland), and his colleagues have tried to clarify the matter by looking at 63 previously published reports on the topic of epidural steroid injections and their success in providing relief to patients with lower back pain.
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. Epidural corticosteroid injections are perceived as being more effective than they are”.
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. However, subjects who had spinal narrowing did not experience these benefits.
On top of this, even the subjects who had ruptured discs did not experience long term benefits. Their pain relief was significant, but short lived. And epidural steroid injections did not prove to offer any pain relief in cases where patients were in need of surgery.
Dr. Chou and his colleagues reached the same conclusions even after trying different steroid and different injection technique.
But the good news is that very few of the subjects experienced serious complications because of the treatment. Minor complications, on the other hand, were a little more common and included nerve root irritation, blood clots and bleeding.
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”. He went on to add that he always lets his patients know that “the natural history for both of these conditions is for improvement over time”.
The study has sparked controversy among field experts as some have accepted the findings, while others have rejected them.
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 cannot be taken seriously in day to day practice.
He also believes that epidural steroid injections are not meant to be seen as a long term solution, but as a temporary solution that momentarily improves a patient’s symptoms so that they can get some rest and acquire the ability to tolerate physical therapy.
The findings were published recently, in the journal Annals of Internal Medicine.
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