Epidural Steroid Injection for chronic low back pain [Neurosurgery Wiki]

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====== Epidural Steroid Injection for chronic low back pain ======
Epidural Steroid Injection for [[chronic low back pain treatment]] are a commonly used short-term option for treating low back pain and sciatica associated with inflammation. Pain relief associated with the injections, however, tends to be temporary and the injections are not advised for long-term use. An NIH-funded randomized controlled trial assessing the benefit of epidural steroid injections for the treatment of chronic low back pain associated with spinal stenosis showed that long-term outcomes were worse among those people who received the injections compared with those who did not.

Transcutaneous electrical nerve stimulation (TENS) involves wearing a battery-powered device consisting of electrodes placed on the skin over the painful area that generate electrical impulses designed to block incoming pain signals from the peripheral nerves. The theory is that stimulating the nervous system can modify the perception of pain. Early studies of TENS suggested that it elevated levels of endorphins, the body’s natural pain-numbing chemicals. More recent studies, however, have produced mixed results on its effectiveness for providing relief from low back pain.

Injecting methylprednisolone acetate into the facet joints is of little value in the treatment of patients with chronic low back pain
((Carette S, Marcoux S, Truchon R, Grondin C, Gagnon J, Allard Y, Latulippe M. A
controlled trial of corticosteroid injections into facet joints for chronic low
back pain. N Engl J Med. 1991 Oct 3;325(14):1002-7. PubMed PMID: 1832209.)).