Efficacy of Epidural Steroid Injections in Axial Back Pain

By | February 20, 2012

Axial low back pain differs from radicular pain in that the pain is confined to the back. It is often caused by different factors than the radicular variety.

Patients with axial back pain, in general respond less well to epidural steroid injections than do chronic pain patients with primarily radicular symptoms. Like patients with radicular back pain, many patients, those whose primary site of inflammation is intracanalicular, will feel better after an epidural injection of steroids. But for the 50% or more of patients with axial low back pain whose primary source of pain is extracanalicular, such as in primary facet arthropathy, spondyloarthropathy, scoliosis and discitis, epidural steroids are unlikely to have a significant long term effect. The other major problem is that spontaneous healing is less likely to occur with these conditions. If long term success is to be achieved the primary cause of the pain must be found and treated. That is why at Schlesinger Pain Centers, after an initial trial of lumbar epidural steroid injection (LESI), other forms of therapy, such as facet joint injections, physical therapy, yoga therapy, spinal traction, inversion therapy and massage are actively explored.

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