AAN Systematic Review Examines Effectiveness of Epidural Steroid Injections for Chronic Back Pain - Video

The American Academy of Neurology (AAN) has developed a new systematic review to summarize for neurologists and other clinicians the evidence for epidural steroid injections and whether they reduce pain and disability for people with certain kinds of chronic back pain. The systematic review is published online in Neurology®.

With an epidural steroid injection, a steroid or corticosteroid medication is injected into a part of the spine called the epidural space. The goal is to help reduce certain kinds of back pain.

For the review, researchers analyzed all available studies over a 16-year period. A total of 90 studies were examined. The review focused on the use of epidural steroid injections to reduce pain for people with radiculopathy and spinal stenosis.

For people with radiculopathy, the review says studies show epidural steroid injections may be effective at modestly reducing pain and disability for up to three months after the procedure.

When compared to people not receiving the treatment, 24% more people receiving the treatment reported reduced pain, and 16% more reported reduced disability for up to 3 months. The treatment may also reduce disability for up to six months or more, with 11% more of those treated reporting reduced disability.

For people with spinal stenosis, studies show epidural steroid injections might modestly reduce disability for up to six months or more after the procedure.

When compared to people not receiving the treatment, 26% more people receiving the treatment reported reduced disability up to three months, and 12% more for up to six months or more. The treatment was not found to reduce pain for up to three months.

“Our review affirms the limited effectiveness of epidural steroid injections in the short term for some forms of chronic back pain,” said author Pushpa Narayanaswami, MD, of Beth Israel Deaconess Medical Center in Boston and a Fellow of the American Academy of Neurology. “We found no studies looking at whether repeated treatments are effective or examining the effect of treatment on daily living and returning to work. Future studies should address these gaps.”

Reference: https://www.aan.com/PressRoom/Home/PressRelease/5231