Epidural Steroids for Cervical Radicular Pain: Little Benefit

Data on epidural steroid injections for cervical radiculopathy are largely observational, and results of the few small randomized trials have been inconclusive. In this multicenter trial, U.S. investigators randomized 169 patients with arm pain attributed to cervical radiculopathy to receive either single initial epidural steroid injections (which could be repeated at 1 month and 3 months, if needed), drug therapy (gabapentin or nortriptyline) plus physical therapy, or both interventions. Criteria for enrollment included pain duration of 1 month to 4 years (median duration, 0.8 years) and magnetic resonance imaging findings that supported clinical presentation.

At 1 month, arm-pain scores (the primary outcome) improved in all three groups, w…