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Epidural corticosteroid injections are given with astounding frequency, despite minimal evidence of efficacy. A 2012 meta-analysis showed that epidural steroids have minimal value in treating patients with lumbosacral radiculopathy (NEJM JW Gen Med Jan 1 2013 and Ann Intern Med 2012; 157:865). Now, in an updated meta-analysis, researchers have examined outcomes of placebo-controlled trials for both lumbosacral radiculopathy (30 studies) and spinal stenosis (8 studies). All studies involved patients with radiating leg pain; in some studies, imaging confirmation of nerve-root compression was required.
For lumbosacral radiculopathy, epidural steroids were associated with a small, statistically significant improvement in average pain intensity d…