Epidural Steroid Injection Pain Relief Success Rates

Epidural Steroid Injection Pain Relief Success Rates

Patients will find that the benefits of an epidural steroid injection include a reduction in pain, primarily in leg pain (also called sciatica or radicular pain). Patients seem to have a better response when the epidural steroid injections are coupled with an organized therapeutic exercise program.

Epidural Steroid Injection Success Rates

While the effects of an epidural steroid injection tend to be temporary (lasting from a week to up to a year) an epidural steroid injection can deliver substantial benefits for many patients experiencing low back pain.

  • When proper placement is made using fluoroscopic guidance and radiographic confirmation through the use of contrast, > 50% of patients receive some pain relief as a result of lumbar epidural steroid injections.
  • Pain relief is more often felt for primary radicular (leg) pain and, less prominently, low back pain.
  • The pain relief and control brought on by injections can improve a patient's mental health and quality of life, minimize the need for painkiller use, and potentially delay or avoid surgery.
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Success rates can vary depending on the condition that patient has and the degree of radicular leg pain that accompanies it:

  • Recent research reports that lumbar epidural steroid injections are successful in patients with persistent sciatica from lumbar disc herniation, with more than 80% of the injected group with disc herniation experiencing relief (in contrast to 48% of the group that received a saline placebo injection)1.
  • Similarly, in a study focused on a group of patients with lumbar spinal stenosis and related sciatica symptoms, 75% of patients receiving injections had more than 50% of pain reduction one year following the injections. The majority also increased their walking duration and tolerance for standing2.

Nonetheless, there is still some skepticism about the efficacy of injections and the appropriateness of injections for most patients. As noted previously, much of the controversy is generated by studies that analyze injection outcomes where fluoroscopy and radiographic contrast were not used to ensure accurate placement of the steroid solution at the level of pathology, or do not confirm that the injection was in fact made directly into the epidural space, which would diminish its effectiveness considerably.

References

  1. See Lutz, GE, et al: Fluoroscopic transforaminal lumbar epidural steroidsL an outcome study. Arch. Phys Med Rehab, Nov. 1998, Vol 79(11), pp. 1362-6. Using analysis of prospective randomized study comparing transforaminal lumbar epidural injection with lumbar paraspinal trigger-point injection for treatment of patients with sciatica from herniated discs.
  2. See Botwin, KP et al. Fluoroscopically guided lumbar transforaminal epidural steroid injections in degenerative lumbar stenosis: an outcome study. Am J Phys Med Rehab Dec 2002, Vol 81(12), pp. 898-905.
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