Is it an overhyped solution?
A recent review from the American Academy of Neurology (AAN) has found limited evidence supporting the effectiveness of epidural steroid injections for certain types of chronic lower back pain. These injections, which involve the administration of a steroid or corticosteroid into the spine, are commonly used for pain relief.
Published on February 12 in Neurology, the systematic review examined the potential benefits of epidural steroid injections in treating chronic back pain. Lead author Dr. Carmel Armon, from Loma Linda University School of Medicine, explained that while chronic back pain can significantly affect daily life, studies show that epidural steroid injections may provide only modest pain relief in some cases. They can potentially reduce pain for up to three months and disability for up to six months or more, although the benefits are limited.
The researchers analyzed 90 studies conducted over 16 years, focusing on patients experiencing pain from conditions like radiculopathy (pinched nerve) and spinal stenosis (compression of the spinal cord or nerves), specifically in the lower back. However, there was insufficient data to evaluate the efficacy of these injections for neck conditions.
For patients with a pinched nerve, the review found that epidural steroid injections led to a modest reduction in both pain and disability. Compared to those not receiving injections, 24% more patients reported less pain and 16% more reported less disability after three months. Additionally, 11% more patients reported sustained improvement in disability after six months. For those with spinal stenosis, the injections seemed to alleviate disability but did not reduce pain, with 26% of patients reporting less disability after three months and 12% reporting improvement after six months.
The review also noted that there is not enough evidence to determine the effectiveness of epidural steroid injections for neck conditions. Dr. Pushpa Narayanaswami, co-author of the study, emphasized the limited short-term benefits of these injections for certain chronic back pain conditions and highlighted the need for further research, particularly on the long-term effectiveness, the impact on daily activities, and the potential for repeated treatments.
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