Steroid injections for spinal stenosis?

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Steroid injection for spinal stenosisResearch has been carried out which indicates steroid injections to provide back pain relief in older adults are sometimes ineffective. The findings, published in Spine medical journal showed that patients receiving steroid injections for lower spinal degeneration could fare worse than those who did not receive the treatment.

The research, carried out 276 older adults with spinal stenosis in the lower back. Spinal stenosis, is a condition where the open spaces in the spinal column gradually narrow, sometimes causing pressure on the spinal nerves, causing back pain. Symptoms of spinal stenosis are pain or cramping in the legs or buttocks, often when walking or standing over a long time.

Treatments for spinal stenosis range from the use anti-inflammatory painkillers or physical therapy to surgery. Steroid injections, which may be resorted to before opting for surgery, can reduce inflammation, and provide short term back pain relief.

The study, carried out by the Thomas Jefferson University of Philidelphia showed that patients who received steroid injections did experience back pain relief over several years, but they did not do as well as those sufferers who opted for conservative back pain treatment or undertook surgery earlier.

Another observation was that those steroid users who did subsequently opt for surgery did not improve as much as patients who opted not to receive steroid injections prior to surgery.

Lead researcher spinal surgeon Dr. Kris Radcliff, suggested that the reasons weren’t clear, advising caution over the results, saying “Some of the study patients were randomly assigned to get steroid injections, but others were not — they opted for the treatment. So it’s possible that there’s something else about those patients that explains their worse outcomes. “I think we need to look at the results with some caution. “

On the other hand, he said, steroid injections themselves might hamper healing in the long run. One possibility is that injecting the materials into an already cramped space in the spine might make the situation worse, once the initial pain-relieving effects of the steroids wear off, Radcliff explained, “But that’s just our speculation.”
Radcliff said he wouldn’t discourage the use of steroid injections for patients who want to try them. “It’s still reasonable to offer this as an option,” he said. “These patients did improve; they just didn’t improve as much as the others.” He also pointed out that spinal stenosis is just one cause of low back and leg pain. Other conditions can pinch a nerve and cause similar symptoms, such as a herniated disc.

The patients in the current study came from 13 spine treatment centers in 11 U.S. states. Radcliff stated there was no evidence of infections or other serious side effects from the treatment. “So, it did appear to be safe,” he said.

The study was funded by the U.S. National Institutes of Health and the U.S. Centers for Disease Control and Prevention.