Back problems are a result in dysfunctions in movement and movement patterns as was discussed in the Annals of Internal Medicine. A recent study also published in this same journal is now suggesting the Epidural Injections for back pain may be no more effective that 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 and patients who have been in motor vehicle accidents and who are experiencing these types of symptoms often are sent for this type of intervention.
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. 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.
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.