Steroid Injections Do Not Help Reduce Back Pain in Spinal Stenosis Patients: Study

Taking steroid shots will not reduce back pain in spinal stenosis patients, finds a study.

Spinal stenosis is an age-induced condition categorized by constriction of spaces around the spine that adds more pressure on the spinal cord and nerves. It usually occurs in the neck and lower back and causes severe pain, numbness and muscle weakness in patients.

People suffering from spinal stenosis are treated with gluco-corticosteroids along with local anesthetic lidocaine to reduce pain and ease swelling and inflammation resulting from suppression of the nerves. Researchers from the University of Washington tested the efficacy and side-effects of this method on 400 people suffering from back and leg pain caused by lumbar spinal stenosis for almost six weeks. The participants either received local anesthetic drug alone or with a combination of gluco-corticosteroids.

The study monitored the reactionary responses like treatment satisfaction, depression and differences in subjects after three weeks and rated their pain intensity level on a scale of 0-10. In addition, the subjects answered a questionnaire that helped assess their physical limitations caused by severe pain before and after taking steroid shots.

For the first three weeks, both groups showed progress. Later, only individuals who were on steroid injections reported minor reduction in leg pain and slightly better function. However, at the end of the trial, experts recorded no variation in terms of pain and function between both groups.

Nearly 67 percent of those who received gluco-corticosteroids were either 'very' or 'some what' satisfied with treatment compared to 54 percent of patients given only anesthetic drug. Gluco-corticosteroids also helps improve mood and bring down feelings of fatigue and depression. These might have impacted their satisfaction level, believe the authors.

It was also observed that people who received gluco-corticosteroids injections were likely to have low serum cortisol levels and had high probability of facing its systemic effects like reduced bone density and risk of fractures.

"Compared to injections with local anesthetic alone, injections with gluco-corticoids provided these patients with minimal or no additional benefit," said Janna L. Friedly, study author and assistant professor of rehabilitation medicine at the University of Washington in a news release.

"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," she added.

The research was funded by the U.S. Agency for Healthcare Research and Quality. More information is available online in the New England Journal of Medicine.

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