AHRQ-Funded Study Finds Little Benefit From Corticosteroid Injections for Common Cause of Spine-Related Pain

The addition of a corticosteroid to epidural injections of an anesthetic does not enhance pain reduction in patients with lumbar spinal stenosis, a common cause of lower back and leg pain, according to a new AHRQ-funded study. The findings, released in an abstract and article published in the July 3 issue of New England Journal of Medicine, come from the first major clinical trial comparing epidural injections of anesthetic with and without corticosteroids for spinal stenosis. Researchers funded by AHRQ studied patients six weeks after treatment and found those whose lidocaine anesthetic was supplemented with a corticosteroid experienced minimal to no additional benefit compared with patients who received injections of anesthetic alone. Epidural injection of anesthetic with corticosteroid is a common treatment for lumbar spinal stenosis. It is estimated that more than 2.2 million lumbar epidural steroid injections are given each year to Medicare patients. Rates and associated costs of the procedure have increased nearly 300 percent over the last two decades. “This study raises questions about the benefits of combining corticosteroids with an anesthetic for patients with lumbar stenosis, and it will help patients and their physicians make better informed decisions about treatment options,” AHRQ Director Richard Kronick, Ph.D., said in an AHRQ press release about the study.