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Think an injection will help?

7 July 2014 No Comment

Might need to think again. An article in The New York Times has cast uncertainty over the therapeutic value of spinal steroid injections. In a recent study, published in the New England Journal of Medicine no less, patients were given a plain anaesthetic injection, or the anaesthetic combined with the steroid. Here are a few quotes that summarise the results:

  • “the study, the largest randomized trial evaluating the treatment, found that patients receiving a standard stenosis injection — which combine a steroid and a local anesthetic — had no less pain and virtually no greater function after six weeks than patients injected with anesthetic alone.”
  • “It’s sort of become the thing you do. You see this abnormality on the M.R.I. and the patient complains, and immediately, you send the patient for an epidural injection.”
  • Some people can still benefit from injections, he said, but now physicians “will be more cautious” and patients should ask, “Should I really do this?’ ”
  • Mostly, steroid injections are safe, carrying small risks of infection, headaches and sleeplessness. But in April, the Food and Drug Administrationwarned that they may, in rare cases, cause blindness, stroke, paralysis or death, noting that injections have not been F.D.A.-approved for back pain and their effectiveness has “not been established.”
  • The study provides evidence to tell some patients, “This probably isn’t going to work very well for you,”
  • And because some participants received two injections without greater benefit, “it strongly speaks against the practice of performing multiple injections.

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