By Stephen Beech

Epidural steroid injections for chronic back pain only have a “limited” effect, warns new research.

The common treatment may “modestly” reduce pain in some situations for up to three months and reduce disability for some people for up to six months, say scientists.

The findings come from a new systematic review from the American Academy of Neurology (AAN) to summarize for neurologists and other doctors the evidence for epidurals and whether they reduce pain and disability for people with certain kinds of chronic back pain.

An epidural involves a steroid or corticosteroid medication being injected into a part of the spine called the epidural space. The goal is to help reduce certain types of back pain.

Study author Dr. Carmel Armon, of Loma Linda University School of Medicine in California and a Fellow of the American Academy of Neurology, said: “Chronic back pain is common and can negatively impact a person’s quality of life, making it difficult to move, sleep and participate in daily activities.

“In our review, studies show epidural steroid injections may have limited efficacy.

“They may modestly reduce pain in some situations for up to three months and reduce disability for some people for up to six months or more.”

For the review, published by the journal Neurology, researchers analyzed 90 studies from the last 16 years.

The review focused on the use of epidural steroid injections to reduce pain for people with radiculopathy and spinal stenosis.

Radiculopathy is a condition caused by a pinched nerve in the spine, while spinal stenosis is a condition where the spinal cord or nerves have become compressed because the space around the spinal cord has become too small.

For people with radiculopathy, the review says studies show epidural steroid injections may be effective at modestly reducing pain and disability for up to three months after the procedure.

When compared to those not receiving the treatment, 24% more people receiving the treatment reported reduced pain, and 16% more reported reduced disability for up to three months.

The treatment may also reduce disability for up to six months or more, with 11% more of those treated reporting reduced disability.

Most of the reviewed studies looked at people with radiculopathy in their lower backs, so it is unclear how effective the treatment is for those with radiculopathy in their necks.

For people with spinal stenosis, studies show epidural steroid injections might “modestly” reduce disability for up to six months or more after the procedure.

When compared to people not receiving the treatment, 26% more people receiving the treatment reported reduced disability up to three months, and 12% more for up to six months or more.

The treatment was not found to reduce pain for up to three months.

All the studies looked at people with stenosis in their lower backs, so researchers do not know how effective the treatment is for people with stenosis in their necks.

Study co-author Professor Pushpa Narayanaswami, of Beth Israel Deaconess Medical Center in Boston, said: “Our review affirms the limited effectiveness of epidural steroid injections in the short term for some forms of chronic back pain.”

She added: “We found no studies looking at whether repeated treatments are effective or examining the effect of treatment on daily living and returning to work.

“Future studies should address these gaps.”