Many patients get steroid shots to temporarily relieve pain from a pinched nerve in the back or lumbar spinal stenosis. However, there is little evidence to show the long-term effectiveness of this treatment. A new study suggests that the injections may even do more harm than good.
A team of researchers recently examined data from a previous study on back pain in order to determine whether patients who received epidural steroid injections (ESI) experienced improved clinical outcomes, or a lower rate of surgical interventions, than patients who did not receive such injections. Patients with lumbar spinal stenosis who received ESI were compared with patients who did not receive the injection over the course of the four-year study.
At the start of the study, ESI patients expressed a higher preference for nonsurgical treatments. However, ESI did not appear to help these patients avoid surgery. Those who ultimately underwent surgical treatment experienced a longer surgical duration and longer hospital stay than those who had not received the injections. Over the four-year study period, there was significantly less improvement in physical function among ESI patients, even among those who went on to have back surgery. These results suggest that steroid injections are associated with worse outcomes in the treatment of spinal stenosis.
Earlier research has also questioned the efficacy of epidural steroid injections for treating chronic back pain and sciatica. What’s more, spinal injections have been linked to bone loss and fractures in elderly patients.
Radcliff K et al. Epidural steroid injections are associated with less
improvement in patients with lumbar spinal stenosis: A subgroup analysis of the spine patient outcomes research trial. Spine 2013; 38 (4): 279-291.