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Steroid Shots Disappoint in Back Pain Study
Date:3/7/2013

By Amy Norton
HealthDay Reporter

THURSDAY, March 7 (HealthDay News) -- Older adults who get steroid injections for degeneration in their lower spine may fare worse than people who skip the treatment, a small study suggests.

The research, published recently in the journal Spine, followed 276 older adults with spinal stenosis in the lower back. In spinal stenosis, the open spaces in the spinal column gradually narrow, which can put pressure on nerves. The main symptoms are pain or cramping in the legs or buttocks, especially when you walk or stand for a long period.

The treatments range from "conservative" options like anti-inflammatory painkillers and physical therapy to surgery. People often try steroid injections before resorting to surgery. Steroids calm inflammation, and injecting them into the space around constricted nerves may ease pain -- at least temporarily.

In the new study, researchers found that patients who got steroid injections did see some pain relief over four years. But they did not fare as well as patients who went with other conservative treatments or with surgery right away.

And if steroid patients eventually opted for surgery, they did not improve as much as surgery patients who'd skipped the steroids.

It's not clear why, said lead researcher Dr. Kris Radcliff, a spine surgeon with the Rothman Institute at Thomas Jefferson University, in Philadelphia.

"I think we need to look at the results with some caution," he said. Some of the study patients were randomly assigned to get steroid injections, but others were not -- they opted for the treatment. So it's possible that there's something else about those patients that explains their worse outcomes, Radcliff said.

On the other hand, he said, steroid injections themselves might hamper healing in the long run. One possibility is that injecting the materials into an already cramped space in the spine might make th
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