Will a back pain injection work?

A back pain injection is often offered to people with longstanding back pain. The problem is nobody is sure if they work or not! However, a recent study has tried to give us some clearer guidance. To start with it's worth knowing that there are a few different types of injection.

There are several  different types of back pain injection

These include:

• epidural steroid injections, which are into the space between the vertebra and the spinal cord
  
  
• facet joint injections are injections into one or several of the paired facet joints in the low back.
  
  
•  occasionally, back muscles and ligaments will be injected too.

The main reason for these injections is to reduce pain. But, there is no clear evidence whether they work, which type of injection is best or even which injected drug is best. To help us out with these dilemmas the respected Cochrane library undertook a systematic review of all the studies published about this treatment.

Do back pain injections work?

The Cochrane reviewers  found 18 studies that they thought were of a high enough standard to be included. They couldn’t combine the results because the studies were all slightly different, which is a shame, but they did form some conclusions.


They found:

• only five of the 18 trials reported significant results in favour of a back pain injection
  
  
• in half of the 18 studies, side effects such as headache, dizziness, short term pain, tingling and numbness and sickness were reported in a few patients.

Based on these results, the reviewers decided that there is no strong evidence for or against the use of any type of injection therapy if you have lower back pain.

So after all that we are none the wiser!

Despite that, for me, this review contains some very useful information.

• In particular it is important for people with back pain to understand that an injection may not be the cure they are seeking.
  
  
• It may help some but it certainly won't help everyone. But it may be worth a try if someone has run out of other options.

In the same vein another interesting study published this year looked at whether epidural steroid injections reduced the need for back surgery. The results from this trial are really fascinating, read more about this type of back pain injection here.

References

1.  Staal, J.B., de Bie, R., de Vet, H.C., Hildebrandt, J. & Nelemans, P. Injection therapy for subacute and chronic low-back pain. Cochrane Database Syst Rev (2008).

UPDATE 2010 - This review has been updated but the conclusions remain unchanged.

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25-Jan-2013