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==Overview==
==Overview==

Revision as of 22:03, 23 August 2012

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Medical Therapy

  • A meta-analysis of randomized controlled trials by the Cochrane Collaboration found that injection therapy, usually with corticosteroids, does not appear to help long term out come regardless of whether the injection is facet joint, epidural or a local injection.[3] Most clinicians however feel that proper use of various types of injection therapy (epidural steriods, anesthetic facet region injection, proliferative ligament injection) are an important tool in their arsenol for the treatment of back pain.
  • At least one study of intramuscular corticosteroids found no benefit [4] Herbal analgesics may also be effective. It may very well be the case that steriods in and of themselves are not the answer as clinical improvement has been both reported and published numerous times with other injections (anesthetics, etc).

References

  1. van Tulder M, Touray T, Furlan A, Solway S, Bouter L. "Muscle relaxants for non-specific low back pain". Cochrane Database Syst Rev: CD004252. PMID 12804507.
  2. van Tulder M, Scholten R, Koes B, Deyo R. "Non-steroidal anti-inflammatory drugs for low back pain". Cochrane Database Syst Rev: CD000396. PMID 10796356.
  3. Nelemans P, de Bie R, de Vet H, Sturmans F. "Injection therapy for subacute and chronic benign low back pain". Cochrane Database Syst Rev: CD001824. PMID 10796449.
  4. Friedman B, Holden L, Esses D, Bijur P, Choi H, Solorzano C, Paternoster J, Gallagher E (2006). "Parenteral corticosteroids for Emergency Department patients with non-radicular low back pain". J Emerg Med. 31 (4): 365–70. PMID 17046475.