Study: Glucocorticoid Injection Only Effective for Short-Term Relief of Lower Back Pain

According to a recent study, a single glucocorticoid intradiscal injection (GC IDI) was associated with reduced lower back pain at 1 month, but not at 12 months, in patients with chronic lower back pain and active discopathy.

The prospective, parallel-group, double-blind, randomized, controlled study included 135 patients with chronic lower back pain and active discopathy, and was conducted at 3 tertiary centers in France. All participants underwent discography, and 67 of the patients were randomly assigned to receive a single 25 mg GC IDI of prednisolone acetate.
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The primary outcome of the study was the percentage of patients with lower back pain intensity of less than 40 on an 11-point numerical rating scale in the 2 days before the 1 month visit. Secondary outcomes included persistent active discopathy on MRI and lower back pain intensity at 12 months and spine-specific limitations in activities health-related quality of life, anxiety and depression, employment status, and use of analgesics and nonsteroidal anti-inflammatory drugs at 1 month and 12 months.

The researchers’ findings showed that the percentage of participants with lower back pain intensity less than 40 was higher in the GC IDI group (36 of 65 [55.4%]) compared with the control group (21 of 63 [33.3%]) at 1 month. However, no differences were observed between the groups in the intensity scores for lower back pain at 12 months, as well as most secondary outcomes at 1 and 12 months.

“In chronic [lower back pain] associated with active discopathy, a single GC IDI reduces [lower back pain] at 1 month but not at 12 months,” the researchers concluded.

—Melissa Weiss

Reference:

Nguyen C, Boutron I, Baron G, et al. Intradiscal Glucocorticoid injection for patients with chronic low back pain associated with active discopathy: a randomized trial [published online March 21, 2017]. Ann Intern Med. doi:10.7326/M16-1700.