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Related Experiment Videos

Lumbosacral epidural steroid injections.

D T Cannon1, C N Aprill

  • 1The Hughston Clinic, P.C., Columbus, GA 31908-9517, USA.

Archives of Physical Medicine and Rehabilitation
|March 18, 2000
PubMed
Summary

Epidural steroid injections offer a potential non-surgical option for low back pain and radicular pain by reducing inflammation. Advanced techniques improve accuracy and may help patients avoid surgery.

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Area of Science:

  • Pain Management
  • Neurosurgery
  • Radiology

Background:

  • Epidural steroid injections (ESIs) have been utilized for five decades to treat low back pain and associated leg pain.
  • Early ESI use was empirical and faced controversy, with limited evidence from previous controlled studies due to methodological and technical constraints.

Purpose of the Study:

  • To review the current literature on epidural steroid injections for low back pain and leg pain.
  • To explore the proposed mechanisms of action, including the reduction of epidural and perineural inflammation.
  • To assess the efficacy of modern ESI techniques in potentially obviating surgery for specific patient populations.

Main Methods:

  • Review of accumulated literature on epidural steroid injections.
  • Analysis of studies investigating the anti-inflammatory effects of epidural steroids.
  • Evaluation of recent research employing fluoroscopy and precise steroid placement.

Main Results:

  • A growing body of evidence suggests ESIs reduce epidural and perineural inflammation, contributing to clinical benefits.
  • Current studies utilizing fluoroscopy and precise epidural steroid placement indicate potential for avoiding surgery in select patients with true radicular pain.

Conclusions:

  • Epidural steroid injections remain a relevant treatment modality for low back pain and radicular pain.
  • Advances in technique and imaging, such as fluoroscopy, enhance the precision and potential efficacy of ESIs.
  • ESIs may offer a viable alternative to surgery for carefully selected patients experiencing radicular pain.

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