Epidural Glucocorticoid Injections Show Little Benefit for Spinal Stenosis Treatment

Adding an epidural injection of glucocorticoids to lidocaine offers little pain relief for patients with lumbar spinal stenosis compared with treatment with lidocaine alone, according to the results of a recent study funded by the Agency for Healthcare Research and Quality (AHRQ).

The double-blind trial, published in the July 3, 2014, issue of the New England Journal of Medicine, randomly assigned 400 patients with lumbar central spinal stenosis and leg pain and disability to be treated with epidural injections of glucocorticoids and lidocaine or lidocaine alone. Patients were analyzed based on a disability questionnaire and were asked to rate the intensity of their leg pain.

After 6 weeks, disability and leg pain scores did not significantly differ between the 2 treatment groups.

“This is the first large, multicenter randomized trial to look at epidural steroid injections for spinal stenosis, and we found that injection with corticosteroids and lidocaine provided these patients with minimal or no additional benefit over lidocaine injections,” said lead study author Janna L. Friedly, MD, in a press release from AHRQ. “If patients are considering an epidural injection, they should talk to their doctor about the benefits and risks of the options available.”