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

e situation worse, once the initial pain-relieving effects of the steroids wear off, Radcliff explained.

"But that's just our speculation," he said.

A pain management specialist not involved in the work said it's impossible to pin the blame on epidural steroids based on this study. For one, it wasn't a randomized clinical trial, where all patients were assigned to have steroid injections or not have them, said Dr. Steven Cohen, a professor at Johns Hopkins School of Medicine, in Baltimore.

The patients who opted for epidural steroids "may have had more difficult-to-treat pain, or a worse pathology," Cohen said.

He also noted that there is evidence from other research that epidural steroids can help some patients delay spine surgery.

"Epidural steroids won't work for everyone, but they're going to work for some people," said Cohen, adding that he would "absolutely" suggest patients give them a shot if they want to put off surgery.

Epidural steroids should be seen as a "tool in the toolbox," said Dr. Eric Mayer, of the Center for Spine Health at the Cleveland Clinic, in Ohio.

If the goal is to get some symptom relief and possibly delay surgery, then patients may want to try the injections, according to Mayer.

"This study is interesting," he said. "But it really does nothing to inform medical practice."

Epidural steroids have been the subject of some press recently. U.S. officials are currently investigating a deadly outbreak of fungal meningitis linked to epidural steroids produced by one Massachusetts pharmacy.

The patients in the current study came from 13 spine treatment centers in 11 U.S. states. Radcliff said there was no evidence of infections or other serious side effects from the treatment. "So, it did appear to be safe," he said.

Radcliff said he wouldn't discourage the use of steroid injections for patients who want to try them. "It's still reasonable to offer this as an option," he said. "The
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