A new study found that spinal steroid injections may not be as beneficial as what it is usually perceived in terms of treating back pain. While the intervention may relieve lower back pain due to ruptured disc, the results are fleeting and thus may fail to improve patients' pain experience.
The administration of corticosteroids via the spinal route has become more and more rampant. Previous studies agree to the present claims of the recent study, making guidelines for prescribing doctors somehow conflicting. 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 team of researchers, led by Dr. Roger Chou from Oregon Health & Science University, performed the study by reviewing a total of 63 published data from Ovid MEDLINE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, previous systematic reviews, as well as references. The randomized trials delved into the effects of spinal corticosteroid injections compared to placebo, techniques and overall corticosteroid use.
The findings of the study, published in the Annals of Internal Medicine, show that spinal injections of corticosteroids alleviated pain associated with ruptured discs and subsequently improved overall functioning briefly; however, this was not true for patients diagnosed with spinal stenosis. Long-term findings show that the effects of placebo and spinal injections were not far from each other and the need for surgery remained the same. The researchers also discovered that neither the technique of injection performed nor the type of steroid administered appeared to matter.
"I think the important thing is for patients and clinicians to be able to make informed decisions," Chou wrote in an email to Reuters Health. Spinal steroid injection is identified as more effective that it really is. Patients are then left with limited options for treatment, besides surgery, he added.
The conclusions made by the study were of low quality and thus cannot be used for realistic daily practice of spine medicine, comments Dr. Zack McCormick, physical medicine and rehabilitation specialist from the Northwestern University Feinberg School of Medicine. According to him, the objective of spinal steroid injection is not to provide long-term cure but rather to improve quality of life, provide sufficient sleep and facilitate physical therapy. It is not meant to be an isolated medical intervention hence, further investigations that show the effects of spinal steroid injections in combination with other treatment options such as oral drugs and physical therapy, are necessary as these reflect the correct practice in the clinical setting.
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