Orthopedist Questions New Study on Back Pain

A New York orthopedist is questioning the findings in a new study that says epidural steroid injections may not help relieve back and leg pain.

“This is another study that we need to take very seriously, but my experience is that patients do benefit,” said Thomas Mauri, MD, vice chairman of Orthopedic Surgery at Long Island Jewish Medical Center and North Shore University Hospital and chief of the Division of Spinal Surgery at North Shore University Hospital.

“When we have studies that have a larger number of subjects involved in them, then we will be able to tease out the differences in how patients respond to different treatments. “

The study, published July 2 in the New England Journal of Medicine, involved 400 patients with spinal stenosis.  Patients were given steroid injections and an anesthetic for six weeks. The researchers found that the combination of medications was no more effective than the anesthetic alone.

Spinal stenosis is generally caused by arthritis of the spine and usually occurs in older patients, Dr. Mauri says, although younger patients can get it as well.

The condition causes a narrowing of the open spaces within the spine, which puts pressure on nerves and causes pain or numbness in the back and legs.

Injections for spinal stenosis are given in the lower spine just above the buttocks. But, other medications and methods are also used to alleviate pain, says Dr. Mauri.

“The injections are one other type of treatment,” says Dr. Mauri.” We sometimes give the same type of steroid by mouth prior to trying injections. We’ll also give them physical therapy and have them see a physiatrist for evaluation for other types of treatment.”

In some cases, says Dr. Mauri, the injections have allowed patients to avoid surgery.

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