WebMD Medical News
Louise Chang, MD
March 5, 2007 -- When it comes to treating chronic back pain with sciatica,
epidural steroid injections may only bring small, short-term relief, according
to a group of neurology professionals.
Sciatica is pain running down the back of the leg, where the sciatic nerve
is located. It often accompanies back pain.
In reaching its conclusion, the American Academy of Neurology's Therapeutics
and Technology Assessment Subcommittee reviewed four studies on epidural
steroid injections for back pain with sciatica.
Based on the findings, epidural steroid shots are not recommended for
long-term back pain relief, improving back function, or preventing back
surgery, write neurology professor and subcommittee member Carmel Armon, MD,
MHS, and colleagues.
Armon works at Tufts University's medical school and Baystate Medical Center
in Springfield, Mass.
Taken together, the four studies show that patients who got epidural steroid
shots had a slight drop in pain two to six weeks after the injection, compared
with patients who got epidural shots containing no medicine (placebo
However, the epidural steroids didn't relieve back pain more than the
placebo at 24 hours, three months, or six months after administration, the
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, the
extent of leg and back pain relief from epidural steroid injections, on the
average, fell short of the values typically viewed as clinically
meaningful," Armon says in an American Academy of Neurology news
Armon's team didn't have enough data to evaluate the use of epidural steroid
shots for neck pain.
With few high-quality studies to review, the researchers call for further
studies on epidural steroid injections for neck and back pain.
SOURCES: Armon, C. Neurology, March 6, 2007; vol 68: pp 723-771. News
release, American Academy of Neurology.
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