As a general internist and primary care provider, I have to say that it is well-known by PCPs and specialists that epidural injections are not effective for chronic low back pain. In 15 yrs of practice I can’t recall a pain specialist recommending ESI for back pain alone. Epidurals are often quite effective for radicular pain to the lower extremities. Sometimes the pain never returns. Other times it lasts only months but allows a patient to avoid surgery or high doses of pain medications. If partial or temporary effect is achieved, then I see them offer a second injection which is often more effective or longer lasting. I don’t recall ever seeing an interventional pain specialist give 3 injections when the first 2 were ineffective. I have seen many patients benefit. I’ve seen a much smaller fraction get no response. And though I know there are rare potential adverse effects, none of my patients have suffered any other than temporary soreness at the injection site or temporary elevation in blood glucose levels in diabetics (which can be easily managed).
Medicine is the application of current scientific knowledge to unique individuals. As such, it is imperfect but it is introspective and always adapting, growing and learning. It is unfortunate that investigative journalism, while serving an important function, has to sensationalize and divide to get the attention amidst all the other clamor. The mistrust that is engendered towards physicians in general is not constructive.
An example is those books titled “What your doctor doesn’t want you to know about… ” Really?
Please. We are all patients. Our loved ones are patients, too.
We note these studies not to discourage you from undergoing epidural steroid injections, but rather to help foster well-rounded discussions with your doctor. These injections have been shown to provide excellent pain relief in many patients (particularly those who have had symptoms for less than 3 months, not had a previous spine surgery, are younger than 60 years, and don’t smoke). However, epidural steroid injections are not magic bullets. Before starting injection therapy, talk to your doctor about the specific risks and benefits for you.