Spinal Steroid Injections Offer Temporary Relief for Neck and Back Pain, Says Review

A spinal steroid injection, commonly referred to as an epidural injection, may provide only short-term relief for chronic neck and back pain, according to a recent review by the American Academy of Neurology (AAN).

Spinal stenosis, a condition often affecting adults over 60, occurs when the spinal canal narrows, leading to pain, numbness, or reduced mobility in the neck or lower back. While steroid injections are frequently used to manage symptoms, the review highlights their limitations in providing lasting relief.

According to the AAN, spinal steroid injections reduced disability for 26% more patients for up to three months compared to those receiving other treatments. Pain relief was observed in 24% more patients over two to six weeks. However, the injections did not improve long-term functionality or eliminate the need for surgery.

“Contrary to the individual impression many patients experience pertaining to immediate alleviation of pain, once one looks at the 3- and 6-month mark, most patients would be in the same place they would be if they received the control treatment, without steroids,” said Carmel Armon, MD, a neurologist and co-author of the review from Loma Linda University School of Medicine.

The review, based on 90 studies, primarily addressed lower back pain rather than neck pain, making it unclear how effective the injections are for cervical radiculopathy—a condition caused by a pinched nerve in the neck.

Challenges with Spinal Steroid Injections

The findings highlight the short-term effectiveness of epidural injections, suggesting they may not work for all pain management needs. As chronic back pain remains a common issue, the study confirms the conclusions of a 2007 review, underscoring the importance of discussing treatment options with medical professionals.

Dr. Mark Bicket, an anesthesiologist and director of pain and opioid research at Michigan Medicine, suggested that the review’s findings should encourage patients to discuss personalized care plans with their healthcare providers.

“Some patients find improved mobility even if pain relief is limited,” Bicket said. “And there are people who will get both mobility benefit and pain relief.”

For individuals seeking alternatives, Bicket highlighted the potential benefits of combining epidural injections with treatments like acupuncture or physical therapy. Physical therapy, which is often tried early in the treatment process, can play a role before patients seek advanced interventions.

Long-Term Pain Management Options

While epidural injections may offer temporary relief, long-term management for chronic back pain often involves medications and, in some cases, surgery. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and muscle relaxants can help reduce symptoms for many patients.

For individuals not responding to conservative treatments, surgical options may be necessary. Procedures to relieve spinal stenosis often involve removing parts of a disc or vertebra to create more space around nerve roots, providing potential lasting improvement in mobility and pain reduction.

Conclusion

While spinal steroid injections can offer short-term relief for neck and back pain, their effectiveness diminishes over time. Patients experiencing chronic pain should discuss a comprehensive treatment plan with their healthcare provider, exploring alternative therapies and long-term solutions such as physical therapy, pain medications, or surgery if needed. The review highlights the importance of individualized care in addressing the challenges of managing pain effectively.