POEMs

Epidural Steroid Not Better Than Placebo Injection for Sciatica and Spinal Stenosis Pain and Function

 


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Am Fam Physician. 2016 Feb 15;93(4):315a-316.

Clinical Question

Is epidural corticosteroid injection effective for reducing pain and improving function in patents with radicular low back pain or spinal stenosis?

Bottom Line

It is hard to figure out what to do with these results. On the one hand, steroid injection did not provide a significant benefit compared with placebo injection in patients with radicular pain or spinal stenosis. However, part of the reason for this may be the significant and sustained improvement of pain scores seen with the placebo injection. This improvement might reflect natural history, but it may reflect the ability of patients treated with either injection to reframe the pain, because short-term improvement in function was (unlike pain relief) quickly

POEMs (patient-oriented evidence that matters) are provided by EssentialEvidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, please see http://www.essentialevidenceplus.com. Copyright Wiley-Blackwell. Used with permission.

For definitions of levels of evidence used in POEMs, see http://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford.

To subscribe to a free podcast of these and other POEMs that appear in AFP,search in iTunes for “POEM of the Week” or go to http://goo.gl/3niWXb.

This series is coordinated by Sumi Sexton, MD, Associate Deputy Editor.

A collection of POEMs published in AFP is available at http://www.aafp.org/afp/poems.



 

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