Spinal Injections Not Effective for Back Pain

Injections of a epidural steroids and an arthritis drug did not significantly ease sciatic pain for patients in a new study. In recent years, the number of epidural steroid injections has soared. This is likely because surgery and analgesic drugs have not consistently created lasting relief for many sciatica patients, the researchers of a Annals of Internal Medicine study suggested. Despite the growing use of steroid injections, this study adds to the growing body of research raising questions about the long-term efficacy of epidural steroids for sciatica treatment.

In the study, 81 patients with sciatica were divided into three treatment groups by type of injection: epidural steroid, etanercept (a type of arthritis drug), and a saline solution used as a control. Neither epidural steroid or etanercept significantly relieved radiating leg and low-back pain, and neither produced significant changes over the saline solution. Etanercept may have actually hindered improvements in functional capacity and disability, Crystal Phend of Medpage Today wrote. These results are particularly disappointing given that each injection can cost up to $500-700.

Notably, the epidural steroid group did have slightly better results than the etanercept group. Although these changes weren't statistically significant, the researchers suggested that epidural steroid injections may produce "modest, short-term relief" for some patients.

Chiropractic care may produce more long-lasting results. Studies have shown that chiropractic can be just as effective as surgery without the added costs and risks.

Cohen S, White R, Kurihara C, Larkin T, Chang A, et al. Epidural Steroids, Etanercept, or Saline in Subacute Sciatica A Multicenter, Randomized Trial. Annals of Internal Medicine 2012; 156(8): 551-559.

Phend, Crystal. Shot Delivers Scant Relief for Back Pain. Medpage Today. April 17,2012. Accessed April 23,2012. http://www.medpagetoday.com/PainManagement/

Pittman, Genevra. Spinal injections may not aid lower back pain. Reuters Health. April 16, 2012. Accessed April 23,2012. http://www.reuters.com/article/2012/04/16/us-spinal-injections-idUSBRE83F17P20120416.