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  • Caudal epidural steroid injections no better than saline epidurals or sham injections for the treatment of chronic lumbar radiculopathy

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Therapeutics
Randomised controlled trial
Caudal epidural steroid injections no better than saline epidurals or sham injections for the treatment of chronic lumbar radiculopathy
  1. Bradley Kenneth Weiner1,
  2. Joseph Fernandez-Moure2
  1. 1Department of Orthopaedic Surgery, The Methodist Hospital, Houston, Texas, USA
  2. 2Research Institute, The Methodist Hospital, Houston, Texas, USA
  1. Correspondence to Bradley Kenneth Weiner
    Department of Orthopaedic Surgery, The Methodist Hospital, Houston, 6550 Fannin Street, Suite 2500, Houston, TX 77030, USA; bkweiner{at}tmhs.org

https://doi.org/10.1136/ebmed-2011-100318

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    Commentary on: Iversen T, Solberg TK, Romner B, et al. Effect of caudal epidural steroid or saline injection in chronic lumbar radiculopathy: multicentre, blinded, randomised controlled trial. BMJ 2011;343:d5278.OpenUrlAbstract/FREE Full Text

    Context

    Epidural steroid injections are commonly used for the treatment of lumbar radiculopathies which have failed other conservative measures such as physical therapy or non-steroidal anti-inflammatories. Although the use of such injections has risen considerably over recent years, their efficacy remains unclear. This randomised trial compared disability following epidural steroids, epidural saline or sham injections.

    Methods

    Of 461 patients presenting with chronic radiculopathy (duration >12 weeks), 116 patients met the inclusion criteria and were enrolled in the study. Among several exclusion criteria were patients with secondary gain issues who would be unlikely to respond favourably, prior surgery, pregnancy, deformity, morbid obesity, cauda equina syndrome, severe weakness and severe pain (referred for surgery).

    Two control groups were used, one of which received a sham …

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    Footnotes

    • Competing interests None.