The American Neurological Association (AAN) has developed a new systematic review to summarize evidence of epidural steroid injections in neurologists and other clinicians. The systematic review was published online on Neurology® on February 12, 2025. Updated the 2007 rating by AAN.
Epidural steroid injections cause steroids or corticosteroid drugs to be injected into a portion of the spine called the epidural space. The goal is to reduce certain types of back pain.
“Chronic lower back pain is common and can have a negative impact on a person’s quality of life, making it difficult to travel, sleep and participate in daily activities,” says Loma Linda University School of Medicine in California. said Carmel Armon, MD, and fellow fellow fellows. American Neurology Association.
In our review, studies may have limited effectiveness of epidural steroid injections. They can reduce pain modestly for up to three months in some situations and reduce disability in some people by up to six months or more. ”
Carmel Armon of Loma Linda University School of Medicine in California
For review, researchers analyzed all available studies over the course of 16 years. A total of 90 studies were examined.
This review focused on the use of epidural steroid injections to reduce pain in people with radiculopathy and spinal stenosis. Radiculous disorders are conditions caused by pinched nerves in the spine. Spinal stenosis is a condition in which the spinal cord or nerves are compressed due to the space around the spinal cord being too small.
For people with radiculopathy, this review states that epidural steroid injections may be effective in modestly reducing pain and disorders for up to three months after treatment. Masu.
Compared to those not receiving treatment, 24% more people receiving treatment reported a reduction in pain, with 16% reporting a decrease in disability for up to three months. Treatment can also reduce disability for up to six months or more, with 11% more likely to reduce the number of disability reported by those who have received treatment.
Most of the reviewed studies looked at people with psychotic disorders in the lower back, so it is unclear how effective treatment is for people with psychotic disorders in the neck.
For people with spinal stenosis, studies have shown that epidural steroid injections can reduce disorders up to six months or more after treatment.
Compared to those who were not receiving treatment, 26% of people who were receiving treatment reported a decrease of up to three months and a decrease in disability for up to six months. Treatment was not known to reduce pain for up to three months.
All studies have examined people with stenosis in the lower back, so researchers don’t know how effective treatment is for people with stenosis in the neck.
“Our review confirms the limited efficacy of epidural steroid injections in the short term for some chronic low back pain,” says author Push Panayana Swami, MD, Beth, Boston. He describes fellow fellows from the Israel DeConnes Medical Center and the American Academy. “We have found no studies examining whether repeated treatments are effective or whether they can examine the effectiveness of treatments on returning to daily life or work. Future research should address these gaps.”
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American Neurology Association
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