Practice Patterns and Perspectives on Epidural Steroid Injections by Interventional Pain Physicians

Area of Science:

• Pain Management
• Interventional Pain Medicine
• Spinal Injections

Background:

• Epidural steroid injections (ESIs) are a common treatment for chronic spinal pain.
• Significant practice variations exist among interventional pain physicians regarding ESI procedures.
• This study aimed to evaluate current ESI practices and perceived efficacy for potential standardization.

Purpose of the Study:

• To assess interventional pain physicians' perspectives on the importance of precise injectate placement in ESIs.
• To determine the perceived effectiveness of ESIs for axial versus limb pain.
• To understand physician preferences for fixed versus variable injectate volumes.

Main Methods:

• A survey was distributed to interventional pain physicians via email and social media.
• Data collected included views on injectate placement precision, pain type efficacy, and volume administration strategies.
• Responses from 94 physicians were analyzed to identify practice trends.

Main Results:

• Over 77% of respondents consider precise injectate placement crucial for optimal ESI outcomes.
• Approximately 62% believe ESIs are effective for both axial and limb pain, while 36% focus on limb pain.
• A majority (69%) prefer using a fixed injectate volume, whereas 31% adjust volume based on contrast spread.

Conclusions:

• Interventional pain physicians largely agree on the importance of precise injectate placement for ESIs.
• ESIs are perceived as broadly effective for both axial and limb spinal pain.
• Variability in injectate volume administration highlights a need for further research to guide standardization efforts.