Doubt About Steroids for Spinal Stenosis

Spinal stenosis outcomes not improved for patients who had steroid injections

(RxWiki News) When patients with spinal stenosis don't want surgery, steroid shots are a common treatment. A recent study tested whether steroid shots were actually helpful over the long-term.

Researchers found that steroid shots did not lead to better outcomes compared to surgery for people with spinal stenosis.

In fact, patients who chose steroid shots instead of surgery showed about 50 percent less improvement in scores for pain and physical function.

Patients who got steroid shots and later opted for surgery also showed less improvement in physical function after four years.

"Ask a doctor which spinal treatments are right for you."

Spinal stenosis can be caused by injury or develop slowly over time. In spinal stenosis, the nerves in and around the spine become cramped for space when bones compress or heal from an injury. 

When this happens, it can cause nerve pain in the back or limbs, weakness in the limbs and numbness.

Researchers, led by Kris Radcliff, MD, of the Department of Orthopedic Surgery at Thomas Jefferson University in Philadelphia, wanted to know if the use of steroid injections for spinal stenosis led to long-term benefits for patients.

The researchers looked at data from a larger clinical trial of spinal stenosis. In the trial, people answered questions about their level of pain and their overall physical function at the beginning of the study and four years later. Patients’ answers to those questions were combined into scores for pain and scores for physical function.

Then, researchers compared scores of the 69 patients who got steroid injections in the first three months of the study to the scores of 207 patients who did not.

The study results were surprising. Steroid shots did not help people avoid surgery or to have better function after four years.

What the researchers found was that patients who had steroid injections showed about 50 percent less improvement in physical functioning compared to those who opted for surgery.

Patients who had injections also reported about 66 percent less improvement in pain scores than those who had surgery.

Also, the patients who had injections and later opted for surgery showed about 33 percent less improvement in physical function compared to patients who had surgery without ever having steroid injections.

The authors concluded that steroid injections into the back did not improve outcomes for patients with spinal stenosis.

This study looked at data from patients that were part of a larger trial. The type of steroid shots varied among patients because the shots were not the main focus of the original trial.

This study was published February 15 in Spine. The study was funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases, the Office of Research on Women's Health, the National Institutes of Health, the National Institute of Occupational Safety and Health and the Centers for Disease Control and Prevention.

The authors reported income from royalties, stocks, grants, consultancy and board membership but did not provide specific sources of this financial information.

Review Date: 
February 18, 2013