epidural steroid injections are not effective

What is Lumbar Spinal Stenosis?

Lumbar spinal stenosis is often associated with ageing. It is caused by a narrowing of the spinal canal in the lumbar area (lower back). The spine changes as we age and this leads to the degeneration of the intervertebral discs and facet joints. The ligaments also become thicker with age, which also contributes to the narrowing of the spinal canal. [1]

Symptoms of lumbar spinal stenosis include low back pain, increased pain with walking, as well as stiffness of the legs and thighs, pain, numbness, weakness or cramping of the legs, feet or buttocks. Patients usually achieve pain relief when they sit down.

Epidural Steroid Injections

epidural steroid injections are not effective

Before surgical treatment is suggested, most clinicians start with conservative measures, such as epidural steroid injections, in treating lumbar spinal stenosis.[2] The use of these injections has increased over the years. However, a recent clinical trial showed evidence that epidural steroid injections are not effective, as published in the New England Journal of Medicine.

The study was conducted by Friedly JL et al. (A randomized trial of epidural glucocorticoid injections for spinal stenosis. N Engl J Med 2014 Jul 3; 371:11.).

A total of 400 patients with lumbar spinal stenosis were enrolled in a double-blind randomised controlled trial. These patients were randomised to injections with lidocaine plus corticosteroid or lidocaine alone for six weeks.

According to the study, no significant difference was found in between the two groups after a six-week period. No difference was also found after a secondary analysis, comparing interlaminar and transforaminal injections.

Detailed information on the study is found here.

Lumbar Spinal Stenosis and Chiropractic Care

Symptoms of lumbar spinal stenosis can be improved with chiropractic care. Patients can achieve long-term pain relief and better quality of life with proper spinal adjustments as well as exercise and self-care techniques.

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[1] http://www.back.com/back-pain/conditions/lumbar-spinal-stenosis/
[2] http://www.medscape.com/viewarticle/830500

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