Epidural Injections Give a Knock-Down Punch to Low Back Pain

Injections of steroids such as cortisone are widely used to ease joint pain. The use of epidural steroid injections in the spine, however, is more controversial.

The spinal cord travels in a tube within the bones of the spinal canal. The spinal canal is covered by a material called dura. The space between the dura and the spinal cordis the epidural space It is thought that injecting steroid medicaiton into this space fights inflammation around the nerves, the discs, and the facet joints of the spine.

These researchers used epidural steroid injections in 50 patients to try to assess the injections' usefulness. All 50 patients had low back pain, many with pain into their legs (sciatica). All had tried conservative treatments--such as rest, ice, and anti-inflammatory medications--for at least two months without relief. All 50 patients experienced some pain relief soon after the injection. An average of two years later, 68% of the patients had no pain, 12% had less pain than before the injection, and 20% had the same symptoms as before the injection.

The authors conclude that epidural steroid injections may be helpful for some patients who don't get relief from conservative treatment. They suggest that injections are generally less helpful for patients with degenerative facet joint disease and disc space narrowing, among other conditions. But for many patients, an epidural injection might be just what the doctor orders to knock down the symptoms of low back pain.

Panayiotis J. Papagelopoulos, MD, DSc, et al. Treatment of Lumbosacral Radicular Pain With Epidural Steroid Injections. In Orthopedics. February 2001. Vol. 24. No. 2. Pp. 145-149.

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