Kevin MD recently posted an article where he reviewed the effectiveness of various injections commonly used for low back pain. These consist of  local anesthetics, steroids like cortisone, and pain meds. The article included a summary of an article in the Journal of the American Medical Association, as well as notes from a couple of other reviews previously done on whether injections work well for low back pain. The news wasn’t good:

• In a review of 18 trials, only 6 found that the injections had a positive effect. The authors of this review concluded “There is insufficient evidence to support the use of injection therapy in subacute and chronic low-back pain.”
• In a review of 25 studies, overall there was only “a very small (6-point on a scale of 0-100) improvement in the short-term. No long-term benefit was noted.” In other words, 6% improvement.
• The only country that endorses spinal injections is Belgium. Not us, not the US, not the UK. Just Belgium. The general guidelines issued by these countries are for the kinds of things an Osteopath helps with, such as back exercises, spinal manipulation, rehabilitation, and education (such as lifting and postural advice).
• The overall conclusion: “given the weak scientific evidence base and the availability of noninvasive and more effective alternatives, physicians and policy makers should not recommend the use of injection therapy for patients with low back pain and sciatica.”