PORTLAND, Ore., Aug. 26 (UPI) -- Epidural steroid injections provide short-term relief from back pain but are largely ineffective in the longer term, according to a large review of previous research.
Researchers said that many cases of back pain can be relieved over time without treatment, or at least without drugs. In some cases, they said, surgery is the best option because it aims to actually fix the problem, rather than masking it as injections apparently do.
"These injections may not be as effective as perceived, and decisions should be based on an informed discussion of risks, benefits, and potential options, including surgery, medications and nonpharmacological options like exercise therapy," Dr. Roger Chou, a professor of medicine at the Oregon Health and Science University, told HealthDay.
The researchers reviewed 38 placebo-controlled studies, finding that while the injections provided immediate relief from pain and improvements in function, the benefits were "small and not sustained," having no effect on the long-term potential need for surgery.
In cases of herniated disks, the researchers said the effects of injections wore off within a few weeks. This effect was seen regardless of steroid, dose or injection technique. For spinal stenosis patients, there was no effect from the shots.
Many patients prefer an injection because of fear of surgery, but Dr. Nick Shamie, a professor at the University of California Los Angeles, said doctors need to do a better job of explaining the best treatment options available and helping patients to avoid wasting time and money.
"We have known that steroid injections don't have a lasting benefit," Shamie said. "When you offer a procedure to patients that doesn't have a lasting benefit and ultimately they may need a definitive treatment, the question is, 'should we keep offering them this shorter-lived treatment?'"
The study is published in the Annals of Internal Medicine.