Although they are a common treatment for lumbar spinal stenosis, epidural injections that combine lidocaine and glucocorticoid steroids (corticosteroids) ultimately do not relieve the pain associated with this condition any more effectively than does lidocaine alone, according to study findings recently reported in The New England Journal of Medicine (2014;371:11-21).
The Lumbar Epidural steroid injections for Spinal Stenosis (LESS) trial is the first major clinical trial to compare epidural injections of anesthetic with and without corticosteroids, according to a statement from the University of Washington, Seattle, where lead study author Janna L. Friedly, MD, practices rehabilitation medicine.
The study included 400 U.S. hospital patients aged 50 years and older with lumbar central spinal stenosis and moderate-to-severe leg pain and disability. Half of the patients received epidural injections of lidocaine with corticosteroid, and the other half received lidocaine alone.
Three weeks after treatment, patients who received lidocaine injections supplemented with a corticosteroid reported somewhat less leg pain and better function than did patients who received injections of lidocaine alone. However, at 6 weeks posttreatment, there was no difference between the two groups.