March 5, 2007 — When it comes to treating chronic back pain with sciatica,epidural steroid injections may only bring small, short-term relief, accordingto a group of neurology professionals.
Sciatica is pain running down the back of the leg, where the sciatic nerveis located. It often accompanies back pain.
In reaching its conclusion, the American Academy of Neurology’s Therapeuticsand Technology Assessment Subcommittee reviewed four studies on epiduralsteroid injections for back pain with sciatica.
Based on the findings, epidural steroid shots are not recommended forlong-term back pain relief, improving back function, or preventing backsurgery, write neurology professor and subcommittee member Carmel Armon, MD,MHS, and colleagues.
Armon works at Tufts University’s medical school and Baystate Medical Centerin Springfield, Mass.
Taken together, the four studies show that patients who got epidural steroidshots had a slight drop in pain two to six weeks after the injection, comparedwith patients who got epidural shots containing no medicine (placeboinjections).
However, the epidural steroids didn’t relieve back pain more than theplacebo at 24 hours, three months, or six months after administration, thereview shows.
The epidural steroid shots also didn’t appear to improve the patients’average back function or help patients avoid back surgery.
“While some pain relief is a positive result in and of itself, theextent of leg and back pain relief from epidural steroid injections, on theaverage, fell short of the values typically viewed as clinicallymeaningful,” Armon says in an American Academy of Neurology newsrelease.
Armon’s team didn’t have enough data to evaluate the use of epidural steroidshots for neck pain.
With few high-quality studies to review, the researchers call for furtherstudies on epidural steroid injections for neck and back pain.