Epidural Injections Not Effective for Back Pain

Epidural steroid injection, a common non-surgical treatment of low back pain, appears to be on the rise in the US and UK.1-2 Yet the efficacy of epidural steroid injections remains controversial. Some patients do report pain relief in the short term, but the long term benefits of injections are contested. 3

A new study examined the effects of epidural steroid and saline injections in 133 patients with low-back pain. The patients had suffered from low back pain for over 12 weeks. Participants were given one of three treatments: steroid injections, saline injections or placebo injections. After 6, 12, and 52 weeks, there were no significant differences among the groups in terms of patients' pain, quality of life, and disability. Epidural steroid and saline injections were therefore not effective for low-back pain relief in this study. This led researchers to conclude that epidural steroid and saline injections should not be recommended to patients who have had low-back pain longer than 12 weeks.

"This study is very important when we talk to our patients who have low back pain," noted Hans-Christoph Diener, a neurologist at the University of Essen in Germany. He contended that although this procedure is non-surgical, it can still be invasive. "Our advice should be to stay with conservative treatments like regular exercise, physical therapy, and if necessary intake of non-steroidal anti-inflammatory drugs and behavioral therapy."

Chiropractic is a much better, natural approach to relieving back pain without any of the dangerous complications of epidural injections.

  1. Price C, Arden N, Coglan L, Rogers P. Cost-effectiveness and safety of epidural steroids in the management of sciatica. Health Technol Assess 2005;9:1-58,iii.Quoted in Iverson, et al.
  2. Friedly J, Chan L, Deyo R. Increases in lumbosacral injections in the Medicare population:1994 to 2001. Spine (Phila Pa 1976) 2007;32:1754-60.Quoted in Iverson, et al.
  3. Iverson, Trond, Tore Solber, Bertil Romner, Tom Wilsgaard, Jos Twisk, Audny Anke, ´┐Żystein Nygaard, Toralf Hasvold, and Tor Ingebrigtsen. "Effect of caudal epidural steroid or saline injection inchronic lumbar radiculopathy: multicentre, blinded, randomised controlled trial." BMJ. 2011; 343. d5278 doi: 10.1136/bmj.d5278.
  4. Diener, Hans-Christoph. "Low Back Pain: Time to Put Down the Needle?" Medscape. October 21, 2011. Accessed January 3, 2012. http://www.medscape.com/viewarticle/751916.