Steroid injections don't provide lasting relief from the lower back pain of spinal stenosis, argues a provocative study from the University of Washington in Seattle.
"These steroid injections aren't helpful," says Janna Friedly, MD, an assistant professor of rehabilitation medicine and the study's lead author. "There is no added benefit to the steroid itself, so if people are considering these injections, I would recommend that they consider an alternative," such as exercise or surgery.
For the study, published in the July 3 issue of the New England Journal of Medicine, Dr. Friedly and her research team injected either a lidocaine-steroid compound or lidocaine alone into the spinal canals of 400 patients suffering from stenosis-related back and leg pain.
While the steroid group reported slightly less pain and slightly better function at 3 weeks after their injections, there was no significant difference in the reported effects at 6 weeks, the researchers found.
In an accompanying editorial, Gunnar Andersson, MD, PhD, a professor of orthopedic surgery at Rush University Medical Center in Chicago, concedes that steroid injections don't work or show limited effects on some patients, that it is not possible to determine ahead of time who will benefit from them, and that they shouldn't be relied upon as a long-term solution. But, he argues, they do help some patients against a condition which has no permanent cure.