Understanding whether chronic lower back pain patients with lumbar spinal stenosis benefit from multiple epidural steroid injections prior to the Procedure.

Originally published in , this article is a summary of a study performed to look at the benefit, if any, of more than one epidural steroid injection in the spine before the Procedure. Minimally invasive lumbar decompression (commonly known as the Procedure) and epidural steroid injections are both common treatment options for lumbar spinal stenosis (commonly referred to as LSS), a condition that causes chronic lower back pain in older adults. To determine how to best treat LSS patients, healthcare professionals use a guide to help with the decision-making process (called an algorithm) to pass through non-medical to more invasive therapies that often includes one or more epidural steroid injections. An epidural steroid injection is medication inserted in the lower back to reduce swelling and provide relief from pain. Researchers wanted to look at a change to when in the treatment process the Procedure is carried out. In the study, researchers compared the medical records of participants who had received either just one or no steroid injection prior to the Procedure, to participants who received two or more epidural steroid injections prior to the Procedure. Similar outcomes in both treatment groups in this study proved that giving more than one epidural steroid injection prior to the Procedure did not improve how well patients did and may have delayed patient care. Based on the results of the study, it is recommended that the standard treatment process for LSS patients be changed to give the Procedure either as soon as LSS is diagnosed or after the failure of the first epidural steroid injection.