Steroid injection fails to provide sustained relief of discopathy-associated chronic low back pain │ EULAR

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Takeaway

  • A single glucocorticoid intradiscal injection (GC IDI) reduces chronic low back pain (LBP) associated with active discopathy at one month after the intervention but is no better than placebo at one y.

Why this matters

  • Chronic LBP caused by disc-related inflammation is a common problem.

Study design

  • The investigators randomized 135 patients with active discopathy on magnetic resonance imaging to 25 mg of methylprednisolone in the inter-vertebral disc during a discography or discography alone.
  • The primary outcome measure was the percentage of patients with LBP intensity in the previous 48 hr < 40 on an 11-point numeric rating scale (NRS, 0 no pain - 100 maximal pain) at 1 mo.

Key results

  • At 1 mo the percentage of responders was higher in the GC IDI than control group (55.4% versus 33.3%]; absolute risk difference [95% confidence interval] 22.1 [5.5; 38.7]); P=0.009. In the sensitivity analysis, mean reduction [95% CI] in LBP in...