title: Corticosteroids for Pain of Spinal Origin: Epidural and Intraarticular Administration.
abstract: Targeted interventional delivery of corticosteroids remains a mainstay of treatment for spinal pain syndromes because this approach has a wider therapeutic index than other approaches. The best evidence for analgesic efficacy is in subacute radicular syndromes associated with new-onset or recurrent lumbar radiculitis. Complications often relate to drug delivery technique as much as actions of the steroid itself and require careful consideration and vigilance by the administering physician. Considerable uncertainty persists concerning which patients with chronic pain are most likely to benefit from corticosteroid injections. Matching this treatment option with specific spinal pain syndromes remains a major challenge.
authors.affiliation: Department of Neuroscience, University of Toronto, 27 Kings College Circle, Toronto, ON M5S, Canada; Translational Pain Research Program, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY 14642, USA.
authors.forename: Louisa S
authors.initials: LS
authors.lastname: Schilling
authors.affiliation: Department of Neurosurgery, Translational Pain Research Program, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY 14642, USA. Electronic address: john_markman@urmc.rochester.edu.
authors.forename: John D
authors.initials: JD
authors.lastname: Markman
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007268:Injections, Epidural; D007270:Injections, Intra-Articular; D017116:Low Back Pain / Q000188:drug therapy*; D008159:Lumbar Vertebrae; D010146:Pain / Q000188:drug therapy; D011843:Radiculopathy / Q000188:drug therapy*; D058566:Sacroiliitis / Q000188:drug therapy*; D013130:Spinal Stenosis / Q000188:drug therapy*; D025241:Spondylarthritis / Q000188:drug therapy*; D021801:Zygapophyseal Joint
chemical_list: D000305:Adrenal Cortex Hormones; D005938:Glucocorticoids
keywords: Corticosteroid; Epidural steroid injection; Facet joint; Glucocorticoid; Low back pain; Lumbar stenosis; Sacroiliac joint; Transforaminal