March 5, 2007 -- When it comes to treating chronic back pain with sciatica, epidural steroid injections may only bring small, short-term relief, according to a group of neurology professionals.
Sciatica is pain running down the back of the leg, where the sciatic nerve is located. It often accompanies back pain.
In reaching its conclusion, the American Academy of Neurology's Therapeutics and Technology Assessment Subcommittee reviewed four studies on epidural steroid injections for back pain with sciatica.
Based on the findings, epidural steroid shots are not recommended for long-term back pain relief, improving back function, or preventing back surgery, write neurology professor and subcommittee member Carmel Armon, MD, MHS, and colleagues.
Armon works at Tufts University's medical school and Baystate Medical Center in Springfield, Mass.
Taken together, the four studies show that patients who got epidural steroid shots had a slight drop in pain two to six weeks after the injection, compared with patients who got epidural shots containing no medicine (placebo injections).
However, the epidural steroids didn't relieve back pain more than the placebo at 24 hours, three months, or six months after administration, the review shows.
The epidural steroid shots also didn't appear to improve the patients' average back function or help patients avoid back surgery.
"While some pain relief is a positive result in and of itself, the extent of leg and back pain relief from epidural steroid injections, on the average, fell short of the values typically viewed as clinically meaningful," Armon says in an American Academy of Neurology news release.
Armon's team didn't have enough data to evaluate the use of epidural steroid shots for neck pain.
With few high-quality studies to review, the researchers call for further studies on epidural steroid injections for neck and back pain.