For Back Pain, Steroid Shots No More Effective Than Placebo
A randomized trial of steroid injections for back pain has shown that they are no more effective than a placebo.
Because the long-term benefits of surgery remain unproven and pain medicines often have serious side effects, doctors have increasingly turned to steroid injections to treat lumbosacral radiculopathy, a common cause of back pain. The condition stems from damage to the discs between the vertebrae that often leads to sciatica, numbness or pain in the legs.
Researchers tested 84 adults with back pain of less than six months' duration, dividing them into three groups. They received either steroids, etanercept (an arthritis medicine) or an inactive saline solution in two injections given two weeks apart.
At the end of one month, they were assessed for pain.
Leg and back pain decreased in all three groups, but there were no statistically significant differences among them. The researchers conclude that steroids may provide some short-term analgesic effect, but that the improvement in all of the patients was mainly due to normal healing.
The lead author, Dr. Steven P. Cohen, an associate professor of anesthesiology at Johns Hopkins, was disappointed with the results but said that he still hopes drugs like etanercept might someday be proven effective. But for now, he said, "the strongest evidence for back pain relief is with exercise."
The study appears in the April 17 issue of Annals of Internal Medicine.
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