Back problems are a result of dysfunctions in movement and movement patterns as was discussed in the Annals of Internal Medicine back pain treatment recommendations from February 2017. A recent study also published in this same journal is now suggesting the Epidural Injections for back pain may be no more effective than a placebo, as published in a recent NY Times article.
The idea of epidural steroid injections for radiculopathy and problems due to spinal stenosis has been used for many years by pain management specialists. Patients who have been in motor vehicle accidents and who are experiencing these types of symptoms often are sent for this type of intervention when attorneys and their clients want a larger amount of bills to bring to court.
Our clinical experience is that few patients receive long-term relief from these injections. Since back and even most radicular pain problems are related to mechanical problems in the legs and how the person walks, relief that is offered temporarily by these injections may offer an explanation as to why some people do maintain relief from these injections.
The people who do suggest they have improved are often in the minority and the procedure does nothing other than injecting lidocaine which reduces the pain and inflammation temporarily. These patients often improve better with chiropractic manipulation, soft tissue treatments such as myofascial release, and therapeutic exercise. Those who are not recommended for chiropractic and are sent for these injections often fail to get relief and are often referred for back surgery, which reduces rather than improves spinal mobility. Since movement is the mechanism behind most types of lower back pain and lower back pain can be caused by the feet, legs, upper body, or lower body, a holistic evaluation often leads to a better diagnosis and treatment regimen. Effective treatment improves mobility while reducing pain. While MRI findings may be used to consider any intervention, it is important to realize that years of malfunction are often what we see in most MRI findings that involve chronic lower back problems. Movement is the best medicine according to the Annals of Internal Medicine’s guidelines while avoiding drugs and invasive treatments. Chiropractors offer the best option for the relief of lower back pain and a possible resolution reducing the long-term risk of chronic back pain.
Steroid Shots No Better for Back Pain Than Placebo
By Nicholas Bakalar
Steroid shots are commonly used for back pain, but evidence that they work no better than placebos is mounting.
In a review published Monday in Annals of Internal Medicine, researchers combined data from 30 placebo-controlled studies of epidural steroid injections for radiculopathy (back pain that radiates to the legs) and eight studies of spinal stenosis (back or neck pain caused by narrowing of the spinal canal).
The study showed that for radiculopathy, injections provided some short-term pain relief, but over time were no more likely to be helpful than placebos, and they did not reduce the need for later surgery.
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