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Spine surgeon referral may be more beneficial than multiple epidural injections
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Researchers analyzed the results of a recently published study and determined epidural steroid injections for the treatment of degenerative neck pain and cervical radiculopathy should be limited to patients receiving physical therapy and pharmacotherapy.
In the study, conducted by Stephen P. Cohen, MD, and colleagues, 169 patients with cervical radiculopathy from seven treatment facilities were randomly assigned to one of three treatment groups. Group one received cervical epidural steroid injections only; group two underwent physical therapy plus pharmacotherapy; and group three underwent a combination of physical therapy, pharmacotherapy and epidural steroid injection.
Cohen and colleagues determined all three groups experienced a modest reduction in both arm and neck pain. Although group three was found to have the most improvements, the differences in improvements were not statistically significant, according to the study data. Patients in group three were significantly more likely to have a categorical outcome — or a positive response on a pain and satisfaction questionnaire along with a two-point improvement in arm pain at 3 months; however, the significant difference was not maintained at 6 months.
In their analysis of Cohen and colleagues’ findings, Viren Vasudeva, MD, and John Chi, MD, MPH, explained that the study was in agreement with previous findings that epidural steroid injections did not produce long-lasting benefits compared with conservative treatment in the lumbar spine.
Vasudeva and Chi concluded that, given the increased risk and lack of benefit from the combined procedure, epidural injection may not have a role in the treatment of cervical radiculopathy. – by Robert Linnehan
Disclosures: The authors report no relevant financial disclosures.
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