14 DAY TRIAL // Saline injections are quite effective at treating lower back pain, and could one day replace epidural steroid injections, researchers with the John Hopkins University argue.
In a paper published in the latest issue of the journal Anaesthesiology, the scientists explain that, although they are currently viewed as the standard treatment for lower back pain, epidural steroid injections are linked with several side effects.
Besides, they only seem to work about 60% of the time. As the researchers put it, “Placebo-controlled studies have found benefit only 60 percent of the time and it remains unclear whether the epidural steroids provide long-term pain control or reduce the need for surgery.”
Furthermore, “Meanwhile, experts warn, steroids are a less-than-ideal treatment for some as they can raise blood sugar in diabetic back patients, slow wound healing in those who need surgery and accelerate bone disease in older women.”
Unlike steroid injections, saline ones have not been linked with any noteworthy side effects. What's more, they appear to be equally effective at providing relief.
The John Hopkins University researchers theorize that this is because, contrary to popular opinion, injecting fluid around the spinal cord, and not the steroids themselves, is what eases the pain.
“It may not be the steroids in spinal shots that provide relief from lower back pain, but the mere introduction of any of a number of fluids, such as anesthetics and saline, to the space around the spinal cord,” they argue.
“Just injecting liquid into the epidural space appears to work. This shows us that most of the relief may not be from the steroid, which everyone worries about,” Professor Steven Cohen further stresses.
The researchers say that, until further investigations into this issue are carried out, it would be unwise for them to recommend that people quit treating their lower back pain with epidural steroid injections, and switch to saline solutions instead.
However, they recommend that, in light of these findings, doctors consider limiting the amount of steroids that they inject into their patients' bodies.
“Our evidence does support the notion that, for now, reducing the amount of steroids for patients at risk may be advisable,” study first author Mark C. Bicket argues.