Steroid Injection for Chronic Back has Little Benefit; Study Finds

Chronic back and leg pain are often treated with steroid injections. A new study finds that these injections provide little benefit to the patients.

According to researchers at University of Washington, epidural injections with a glucocorticoid in combination with the local anesthetic lidocaine are no better for treating spinal stenosis- a condition affecting the spine- than local anesthetic alone.

Spinal stenosis is when the spinal canal narrows due to wear and tear in old age. The condition causes pain and discomfort in old people. Each year, hundreds of thousands of dollars are spend on steroid injections to relieve the pain, New York Times reported.

Researchers have now said that a large, randomized study looking into the effectiveness of the steroid plus local anesthetic treatment has found no evidence that steroid injections are better pain-relievers for spinal stenosis. On the contrary, the steroids might be increasing fracture risk in patients.

The study was based on data from 400 patients with lumbar spinal stenosis. Participants were randomly given either local anesthetic or the anesthetic plus a steroid.

After six weeks, researchers found that both groups reported less pain, but there was no significant difference between the two groups.

"Compared to injections with local anesthetic alone, injections with glucocorticoids provided these patients with minimal or no additional benefit." said lead author Dr. Janna L. Friedly, an assistant professor of rehabilitation medicine at the University of Washington, according to a news release.

Patients who got the steroid shot reported greater satisfaction with the treatment; about 67 percent of the steroid plus anesthetic group said that they were "very" or "somewhat" satisfied when compared to 54 percent in the only-anesthetic group. The test group also had improvements in depression symptoms.

Researchers say that glucosteroids are known to improve mood and reduce fatigue, which may explain why people in the test group were more satisfied with the treatment than others.

On the flip side, people in the test group had higher risk of adverse reaction and low morning serum cortisol levels three to six weeks after the injections. Researchers say that the treatment might have broad systemic effects. Patients might have low bone density and increased risk of fractures due to steroid injections.

"If patients are considering an epidural injection, they should talk to their doctor about a lidocaine-only injection, given that corticosteroids do pose risks and this study found that they provided no significant added benefit at six weeks," Friedly.

Additional research is required, study authors said.                       

The study is published in the journal New England Journal of Medicine.