Steroid Shots Give Little Help for Treating Chronic Back Pain

Steroid shots may help in treating chronic back pain. However, a recent study published in The New England Journal of Medicine found that for many patients, the shots were not so effective for reducing pain. 

Lead study author Janna Friedly, M.D., who is also an assistant professor in rehabilitation medicine at the University of Washington in Seattle, examined patients who received corticosteroid injections in combination with local anesthetic or just a local anesthetic.

Researchers looked to determine if the combination treatment lessened pain experienced by the patients more than an anesthetic, alone.

Dr. Friedly and colleagues assigned 400 spinal stenosis patients to either receive a local anesthetic or a combination anesthetic treatment with steroids. The participants were then asked to rate their pain on a scale of 0-10 after receiving the injection for three and six weeks. They were also asked to report on physical limitations from a 0-24 scale range, called the Roland-Morris Disability Questionnaire.

Findings revealed that the steroid group had slightly less pain and physical limitations after three weeks than the anesthetic-only group. However, the analysis showed no significant difference in physical limitation or pain intensity scores between the groups after six weeks of receiving the shots.

Furthermore, researchers found that 67 percent of the patients who received steroids were "very" or "somewhat" satisfied compared to 54 percent of those who received the anesthetic alone.

Researchers said they believe that the outcome may be due to the slight initial benefit witness from the corticosteroid injections. 

"Compared to injections with local anesthetic alone, injections with glucocorticoids provided these patients with minimal or no additional benefit," Dr Friedly said, 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."