Epidural steroid injections for radicular lumbosacral pain: a systematic review.
Most clinical guidelines do not recommend routine use of epidural steroid injections for the management of chronic low back pain. However, many clinicians do not adhere to these guidelines. This comprehensive evidence overview concluded that off-label epidural steroid injections provide small short-term but not long- term leg-pain relief and improvement in function; injection of steroids is no more effective than injection of local anesthetics alone; post-procedural complications are uncommon, but the risk of contamination and serious infections is very high. The evidence does not support routine use of off-label epidural steroid injections in adults with benign radicular lumbosacral pain.
Elsevier Clinical Solutions, Evidence-Based Medicine Center, Philadelphia, PA, USA. Electronic address: t.shamliyan@elsevier.com.
Tatyana A
TA
Shamliyan
Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
J Bart
JB
Staal
Elsevier Clinical Solutions, Evidence-Based Medicine Center, Philadelphia, PA, USA.
David
D
Goldmann
Elsevier Clinical Solutions, Evidence-Based Medicine Center, Philadelphia, PA, USA.
Megan
M
Sands-Lincoln
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects; D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D004305:Dose-Response Relationship, Drug; D019317:Evidence-Based Medicine; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007268:Injections, Epidural; D017116:Low Back Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D011843:Radiculopathy / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
D000305:Adrenal Cortex Hormones
Epidural injection; Low back pain; Lumbosacral radicular syndrome; Steroids