Steroid injections do little for chronic pain

Epidural steroid injections do not provide long-term pain relief for lower back pain that radiates down a leg, according to an American Academy of Neurology guideline published in the March 6 issue of Neurology.

To develop the guideline, the authors analyzed scientific studies on the topic. While the injections can provide some short-term pain relief between two and six weeks after injection, the amount of relief is generally small, according to the lead author, Dr. Carmel Armon, professor of neurology at Tufts and chief of the Division of Neurology at Baystate Medical Center, a Tufts-affiliated hospital in Springfield, Mass.

The authors found that steroid injections usually did not help patients “buy time” to avoid surgery. “The use of epidural steroid injections to treat chronic back pain is increasing over time despite limited quality data,” said Armon. He noted that 1999 Medicare Part B claims for lumbar epidural steroid injections totaled $49.9 million.

In addition, the authors found insufficient evidence to use epidural steroid injections to treat neck pain.

This story ran in the Tufts Journal in April 2007.