Epidural Cortisone Shots: Yea or Nay?

July 14, 2014 9:32 PM

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Epidural steroid injections have become one of the most commonly used pain treatments in modern medicine. In the U.S., we perform an estimated 10-11 million of these procedures each year, with about 20 percent of those coming in the more elderly Medicare population. In fact, I would say that this very procedure is what helped launched the specialty of pain management, also referred to as pain medicine, some 30+ years ago. You see, anesthesiologists are trained on how to position special needles within the epidural space of the spinal canal in order to anesthetize the body for surgery or to treat labor pain. There is a special technique required to perform epidural blocks appropriately, and using this procedure to deliver medications like corticosteroids (cortisone) to alleviate spinal pain was one of the first treatments developed to treat pain as an entity or a disease, as opposed to a symptom. As a result, the subspecialty of pain management grew out of the practice of anesthesia, with a strong emphasis on being able to perform procedures that could effectively treat pain.

Despite the history surrounding spinal injections and the large volume of them that now get performed each year, it has been difficult to find rousing scientific support for their benefit. The New England Journal of Medicine has just published a new study from the University of Washington examining ...

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