What Do We Know About Epidural Steroid Injections for Back Pain?
The American Academy of Neurology (AAN) has just released new guidelines about the use of epidural steroid injections (ESIs) for low back pain.
ESI is used to control back and leg pain caused by pressure on the spinal nerve. This is called lumbosacral radicular pain. The injections work by reducing inflammation and swelling around the nerve.
When doing an ESI, the doctor inserts a needle through the skin so that the tip of the needle is in the epidural space. This space is the area between the bony ring of the spine and the covering of the spine called the dura. The dura is the sac that encloses the spinal fluid and nerves of the spine.
The results of recent studies confirm that ESIs do give some relief of lumbosacral radicular pain. Patients can get relief of painful symptoms for up to three months. ESIs do not cure any of the diseases they are commonly used for. They don't change the patient's level of function or need for surgery.
The AAN does not advise using ESIs on a regular basis. The use of ESIs for neck pain from cervical radiculopathy hasn't been studied fully yet. Better studies with larger numbers of patients are needed in this area.
References: Epidural Steroid Injections. In Pain Medicine News. March/April 2007. Vol. 5. No. 2. Pp. 5.
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