Epidural steroid injections is a common treatment for patients with spinal stenosis but a new study in the February 15 issue of Spine says that the procedure may actually lead to worse outcomes.
Spinal stenosis is a common cause of back and leg pain in which the neural canal becomes narrowed due to either a bulging disc, arthritic changes, a thickening of the ligaments or a combination of all of the above. The Spine study raises serious questions about the benefits of steroid injections for this condition. According to the study author, Dr. Kris E. Radcliff of Thomas Jefferson University, Philadelphia, "There was no improvement in outcome with ESI whether patients were treated surgically or nonsurgically."
Dr. Radcliff and his colleagues compared outcomes for 69 patients who had received steroid injections versus 207 patients who did not. After a four year follow-up, those who had received steroid injections showed significantly less improvement than the non steroid group.
Of the patients who received steroid injections and eventually went on to have surgery, evidence revealed that the surgery was more complicated and the patients spent one extra day in the hospital.
The researchers believe that the "most likely" reason for the worse outcomes in the steroid injection group is that the injections cause worsening of the spinal narrowing.
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