Absence of standardized approach for back pain
There are no standardized practices for administering an epidural steroid injection for back pain. This finding was noted by researchers from the University of California at San Diego and reported at the American Academy of Pain Medicine’s 25th Annual Meeting.
The team of researchers examined many factors such as which all steroids were administered, amount of used steroids, and whether or not a local anesthetic was added with the steroids.
From News-Medical.Net:
“Epidural steroid injections are an important and common option for the treatment of back pain. However, we found that a great variety of techniques are being used. There is no gold standard,” said Dr. Patel, lead author of the study and resident at the University of California at San Diego. “Guidelines may need to be explored with regard to this procedure to increase the effectiveness and decrease risk when using this approach to treat pain.”
Dr. Patel’s study found there were differences from institution to institution regarding which steroid was preferred for these injections. The most common steroids identified for this procedure and respective dose ranges were: depomedrol (dose range 40-120 mg), celestone (dose range 6-15 mg), decadron (dose range 4-12 mg), and kenalog (dose range 10-80 mg).
“These variations in technique might affect why some patients get better results from ESI than others and may also explain good and poor outcomes. This needs to be explored further,” Patel concluded.
Yogesh Patel, MD, and his colleagues at UCSD, identified and surveyed attending pain physicians at interventional pain programs in the US with an aim to compare currently taught techniques in regard to ESI protocols.
