By Allen Dennis, M.D.
CSC Pain Management Physician
Recently a popular medical health TV show, “The Dr. Oz Show,” discussed epidural steroid injections including several concerns with this procedure. Unfortunately, the show focused on a limited undercover report and shared little of the evidence-based data to back their claims of the “dangerous nature” of these injections. It is important to address these concerns with current evidence based data.
Are Epidural Steroid Injections Beneficial?
Multiple studies have found epidural steroid injections to be beneficial in treatment of certain types of spinal pain. The most common indication for epidural steroid injections is pain radiating from the spine to a limb, known as radicular pain. This pain is typically caused by inflammation or compression of a spinal nerve root. The degree of radiation of pain can vary from patient to patient; therefore, adequate diagnosis requires a thorough history, exam and correlation with imaging such as an MRI. Other causes of spine pain that have been shown to respond to epidural injections include spinal stenosis, painful discs and facet pain. In a recent review of numerous studies regarding epidural steroid injections, strong evidence was found for the management of pain from herniated lumbar and cervical discs and acute or persistent nerve root pain with epidural steroid injections. There is moderate evidence for the use of epidural steroid injections for the treatment of discogenic pain, pain from spinal stenosis and facet joint pain. Evidence based data shows typical duration of benefit from epidural steroid injections between 6-12 weeks. Thus, when adequate criteria is used when choosing this technique, there is strong evidence for improvement in pain on a short to moderate term basis.
Epidural steroid injections have been shown to be an efficacious component to conservative management of spine pain. Thorough patient evaluation is key to identifying conditions that typically respond to this therapy. As with any medical therapy, a certain level of risk is involved with epidural steroid injections. This risk is greatly decreased when performed by a well-trained physician using appropriate imaging and standard safety precautions.Allen Dennis, M.D. is a Pain Management physician double board certified in anesthesiology by the American Board of Anesthesiology as well as subspecialty boarded by the American Board of Anesthesiology in pain management. He has extensive experience in the areas of minimally invasive spine medicine and brings a depth of knowledge and experience to CSC in this area. .
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