Related Experiment Video
Updated: Jun 7, 2026
06:03
Operational and Intervention Effects of Targeted Tuina in Lumbar Intervertebral Disc Degeneration Model Rabbits
Published on: July 21, 2023
Epidural steroid injections for low back pain
1Spine and Musculoskeletal Medicine, Rehabilitation Care Services, Veterans Administration, Puget Sound, WA, USA. stouta@uw.edu
Physical Medicine and Rehabilitation Clinics of North America
|October 28, 2010
Summary
Epidural steroid injections (ESIs) are common for low back pain but lack evidence for axial pain. Reviewing literature shows limited support for ESIs treating back pain without leg symptoms.
Area of Science:
- Pain Management
- Neurosurgery
- Musculoskeletal Disorders
Background:
- Epidural steroid injections (ESIs) have been utilized for low back pain for over 50 years.
- Recent trends show increased ESI use for low back and radicular pain without definitive outcome improvements.
- While ESIs show some benefit for radicular limb symptoms, evidence for axial low back pain is scarce.
Purpose of the Study:
- To review the theoretical basis and technical considerations for epidural steroid injections.
- To evaluate the existing literature on different epidural access approaches for treating low back pain without radiculopathy.
- To assess the efficacy of ESIs specifically for axial low back pain.
Main Methods:
- Literature review of studies on epidural steroid injections for low back pain.
- Analysis of theoretical underpinnings and technical aspects of epidural access.
- Examination of evidence supporting ESIs for radicular versus axial pain.
Main Results:
- A significant increase in ESI utilization has not correlated with improved patient outcomes.
- Literature supports ESIs for radicular pain and associated limb symptoms.
- There is a notable lack of scientific literature substantiating the efficacy of ESIs for axial low back pain.
Conclusions:
- The use of epidural steroid injections for axial low back pain lacks robust scientific support.
- Further research is needed to clarify the role and effectiveness of ESIs in managing different types of low back pain.
- Current evidence primarily supports ESIs for radicular pain, not for axial low back pain alone.
More Related Videos
Related Concept Videos
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
01:11Local Anesthetics: Clinical Application as Spinal Anesthesia
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
01:29Drug Delivery: Parenteral Route
The parenteral route is a critical method of drug administration. It delivers compounds directly into the systemic circulation and bypasses the gastrointestinal tract. This approach is particularly advantageous for drugs that exhibit poor absorption or instability when administered orally.
There are three primary parenteral routes: intravenous (IV), intramuscular (IM), and subcutaneous (SC). The IV route introduces the drug directly into the bloodstream, ensuring immediate action. The IM route...
There are three primary parenteral routes: intravenous (IV), intramuscular (IM), and subcutaneous (SC). The IV route introduces the drug directly into the bloodstream, ensuring immediate action. The IM route...
01:29Herniated Intervertebral Disc l: Introduction
Intervertebral disc herniation refers to the displacement of the nucleus pulposus (the gel-like inner core of the disc) through a tear or weakened area in the annulus fibrosus (the outer fibrous ring). The displaced disc material extends beyond the normal boundaries of the disc space and may compress or irritate nearby spinal nerve roots or, less commonly, the spinal cord.Etiology and Risk FactorsHerniation commonly results from degeneration, in which aging reduces disc hydration and...