ST. PAUL, Minn., March 5 (UPI) -- Epidural steroid injections provide only limited short-term relief for lower back pain that radiates down a leg, says a U.S. medical group.
That conclusion is part of new guidelines issued by the American Academy of Neurology, which call into question the increasingly common injections as a lower back pain therapy. The group argues that epidural steroid injections usually do not help patients "buy time" to avoid surgery and are only able to relieve back pain between two and six weeks after injection.
The AAN guidelines also cast doubt on whether medical evidence shows the injections are effective for radicular cervical (neck) pain.
The guidelines were written after an AAN review of the small number of high-quality scientific studies available on epidural steroid injections.
Lead author Carmel Armon, professor of neurology at Tufts University School of Medicine in Boston, said that further well-designed studies are needed to definitively determine the value of the treatment.
"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 said. "(But) the use of epidural steroid injections to treat chronic back pain is increasing over time, despite limited quality data. Recent figures show 1999 Medicare Part B claims for lumbar epidural steroid injections were $49.9 million for 40.4 million covered individuals."
The guidelines appear in the March 6 issue of the journal Neurology.
