A systematic review conducted by the American Academy of Neurology (AAN) evaluated the efficacy of epidural steroid injections in managing chronic back pain. The results were published in Neurology on February 12, 2025.
Epidural steroid injections involve administering corticosteroids into the spine’s epidural space to reduce inflammation and pain. According to Carmel Armon, MD, from Loma Linda University School of Medicine, “Chronic back pain is common and can negatively impact a person’s quality of life by making it difficult to move, sleep, and participate in daily activities.” Given the prevalence of chronic pain conditions, the study aimed to determine this treatment’s short- and long-term benefits.
An analysis of 90 studies spanning 16 years demonstrated that epidural injections provide short-term relief for patients with radiculopathy and spinal stenosis. Radiculopathy, caused by a pinched nerve in the spine, and spinal stenosis, which involves narrowing of the spinal canal, both contribute to significant disability. The findings showed that patients with radiculopathy experienced pain relief and improved function for up to three months, with 24% more patients in the treatment group reporting pain reduction than the control group. Some patients maintained benefits for up to six months.
For spinal stenosis, the injections improved disability but did not significantly reduce pain. Three months post-treatment, 26% more patients reported enhanced functionality, with 12% maintaining improvement at six months. However, the study did not include patients with cervical spinal stenosis, highlighting the need for further research in this subgroup.
According to Pushpa Narayanaswamy, MD, of Beth Israel Deaconess Medical Centre, “Our review confirms the limited efficacy of epidural steroid injections in the short term for some forms of chronic back pain.” The authors emphasize the necessity of further research to explore long-term effects, the impact of repeated treatments, and the overall effectiveness of restoring daily function.
This article is for informational purposes only and should not replace professional medical advice.
