Saline Shots Provide Relief From Lower Back Pain

For those who suffer from chronic back ache and take steroid shots despite the health risks  can now breathe a sigh of relief as researchers say that injection of any fluids, like saline shots, to the space around the spinal cord can also alleviate the pain.

A team of researchers from Johns Hopkins discovered that it is not the steroids in the spinal shots that provide relief from chronic lower back pain, rather it is the mere introduction of any fluids like saline and anesthetics to the space around the spinal cord that provides relief, according to a press statement.

In recent years, the use of epidural steroid injections to cure chronic back pain has skyrocketed. But this puts the person at high risk of several other health problems such as slow wound healing, increase in blood sugar among those with diabetes and acceleration of bone disease among elderly women. These steroid shots weaken the person's muscles as well as spinal bones.

One of the leading causes of disability in the industrialized world is spinal pain. For over 50 years, epidural spinal shots have been the standard treatment for debilitating chronic lower back pain.

Even placebo controlled studies have identified that just 60 percent of the time these shots provide benefits and it still remains a mystery whether the epidural steroids offer long term pain control or lower the need of surgery.

In this latest study, Johns Hopkins anesthesiologist Steven P. Cohen, M.D. along with colleagues reviewed several published studies and discovered that epidural steroid shots were more than twice as likely to give relief as injections of saline or a local aesthetic such as Lidocaine into muscles near the spinal canal. They were sometimes twice as good as the intramuscular injections of steroids.

"Just injecting liquid into the epidural space appears to work," Cohen said in a news statement. "This shows us that most of the relief may not be from the steroid, which everyone worries about."

Concern over the use of epidural spinal shots rose in 2012 when nearly 740 cases were reported in 20 states where people became ill with fungal meningitis and over 55 people lost their lives after receiving epidural injections of contaminated steroids.

Each year patients are recommended to take a limited number of steroid injections. It is too early for the researchers to recommend withdrawal from epidural steroid shots but they state that smaller doses also provide the same benefit.

"Our evidence does support the notion that, for now, reducing the amount of steroids for patients at risk may be advisable," says Bicket, the study's first author.

The study will be published in the journal Anesthesiology.