Older adults who get steroid injections for degeneration in their lower spine may fare worse than people who skip the treatment, a small study suggests.
Radcliff said he wouldn't discourage the use of steroid injections for patients who want to try them. "It's still reasonable to offer this as an option," he said. "These patients did improve; they just didn't improve as much as the others."
He also pointed out that spinal stenosis is just one cause of low back and leg pain. Other conditions can pinch a nerve and cause similar symptoms, such as a herniated disc.
Cohen said that in general, patients with a herniated disc respond better to steroid injections than those with spinal stenosis -- though people with a herniated disc also have a good shot at getting better with no treatment.
Unlike a herniated disc, spinal stenosis is a progressive condition, and it won't be "cured" with any treatment. Even after surgery, Cohen said, your symptoms may well come back at some point.
With epidural steroid injections, there's no consensus on how long you can keep getting them.
But the general guideline is to have no more than three to six injections in a year, Cohen said -- though that's based on expert opinion rather than hard evidence. And just one injection at a time seems to be enough, Cohen noted. Some doctors are in the habit of doing three in one go, but there's no evidence that it benefits patients.
If you do go for epidural steroid injections, it would be wise to make sure your insurance covers it: in the United States, one injection can cost a few hundred dollars.
The study was funded by the U.S. National Institutes of Health and the U.S. Centers for Disease Control and Prevention.
More information
Learn more about low back pain from the U.S. National Institute of Neurological Disorders and Stroke.
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