Considering Injections for Back Pain? Here’s the Research
Does injection therapy for back pain relief really work? Johns Hopkins weights the risks and benefits.
Authors of a systematic review published in the journal Spine took a look at 18 randomized, controlled trials of the effectiveness of injection therapy in nearly 1,200 people with subacute (lasting longer than one month) or chronic (lasting for three months or more) low back pain. Epidural, facet joint, and trigger point injections were reviewed. The studies analyzed excluded people who experienced leg pain and/or muscle weakness due to spinal nerve compression (radiculopathy).
That means that in nearly two thirds of the studies, there was little evidence to suggest that injections were any more effective than placebo in providing short-term pain relief. In addition, none of the studies evaluated long-term effectiveness.
In spite of these findings, experts believe that it is still possible that certain subgroups of people with lingering low back pain could benefit from injection therapy. However, better-designed clinical trials are needed to determine just who those patients may be.
In the meantime, since injection therapy does appear to benefit some people, your doctor may suggest it as an option, particularly if other conservative therapies such as physical therapy have not been helpful and surgery is your next step.
Risks and benefits: Overall, injection therapy is a safe procedure, but adverse effects do sometimes occur. For example, nine of the 18 studies in the Spine review reported side effects, such as headache, dizziness, burning or tingling sensation, and nausea, in small numbers of people.
Injection therapy is not suitable if you are susceptible to excessive bleeding or are taking anticoagulants (drugs that reduce the formation of blood clots). In addition, people experiencing pain due to infection or certain forms of cancer should not receive injections with steroids, since these drugs can weaken the immune system.