Epidural Steroid Injections for Chronic Low Back Pain

James P. Rathmell, MD

Epidural steroid injections are an important treatment modality for patients with radiculopathy owing to spinal stenosis or disc herniation. The precise mode of delivery varies among specialists, although radiographic guidance is thought to increase the accuracy of steroid delivery to the epidural space. While studies and clinical experience have demonstrated improved pain relief and function among some patients, rigorous reviews of the peer reviewed literature fail to demonstrate long-term benefits, underscoring the need for well designed, randomized controlled studies in carefully selected patient populations.

References

Sethee J, Rathmell JP. Epidural steroid injections are useful for the treatment of low back pain and radicular symptoms. Curr Pain Headache Rep. 2009 Feb;13(1):31-4.
Argoff CE, Sims-O'Neill C. Epidural steroid injections are useful for the treatment of low back pain and radicular symptoms. Curr Pain Headache Rep. 2009 Feb;13(1):35-8.
Rathmell JP. A 50-year-old man with chronic low back pain. JAMA. 2008 May 7;299(17):2066-77.

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