Monday, 20 Nov 2017

You are here

Limited Benefits with Intra-Discal Steroid Injections for Back Pain

A a randomized trial published in Annals of Internal Medicine shows that intradiscal glucocorticoid injection has limited (1 month) efficacy in treating low back pain (LBP) associated with active discopathy, yet decreased over time.

A 3 center study in France assessed efficacy of a single glucocorticoid intradiscal injection in patients with chronic low back pain with active discopathy. Patients were randomized to receive either glucocorticoid injection during discography (n = 67) or discography alone (n = 68).

Back pain was assessed after 2 days and at 1, 3, 6, and 12 months. Intradiscal glucocorticoid injection group were more apt to achieve a pain score of <40 (out of 100) compared to the control group (55.4% vs. 33.3%).

This study (and others) question the use of spinal injections in patients with active disc disease and LBP.

 

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

DEA Cracks Down on Illicit Fentanyl

Reuters reports that  U.S. Drug Enforcement Administration (DEA) has declaed it would classify illicit versions of fentanyl at the same level as heroin, allowing criminal prosecution of anyone who possesses, distributes or manufactures illicit versions of the drug.

High Drug Discontinuations and Nonadherence in Fibromyalgia

Compliance and adherence was shown to be quite poor in fibromyalgia (FM) patients, with high rates of drug discontinuation and greater than 60% demonstrated low adherence.

Increasing Deaths and Breaking Bad with Fentanyl

Opioid overdose deaths quadrupled from 1999 to 2015 and accounted for 63% of drug overdose deaths in the United States in 2015. During 2010–2015, heroin overdose deaths quadrupled from 3,036 to 12,989, with heroin and illicitly manufactured fentanyl (IMF) as likely contributors to this trend. (additional citation https://buff.ly/2eHAjpn)

No Evidence to Support Use of Gabapentinoids in Low Back Pain

Management of chronic low back pain (CLBP) is often complex, requiring multiple modalities and meds to control pain. An analysis of studies shows that Gabapentinoids, including pregabalin and gabapentin, have little to no benefits but significant risk of adverse effects.  (Citation source https://buff.ly/2warMSU)

Marijuana Has Little Effect on Most Types of Pain

Cannabis has become a regulated product, and many states have made it available with the intent of treating a variety of medical disorders, including chronic pain. A metanalysis published in Annals of Internal Medicine has shown that while cannabis may help neuropathic pain, it is not proven to benefit other types of chronic pain.