How useful are epidural injections for radicular pain?
This could be the subject of a 50-page chapter with varying conclusions, but in general epidural injections, particularly with local anesthetic and steroids, are useful. A recent review of randomized-controlled trials concluded a modest effect size lasting less than 3 months most often when using a transforaminal approach (>70%), as compared with caudal (60%) and interlaminar (50%) techniques. Further response to injection for a radicular pain, particularly due to herniated disc, is more likely to be positive than when procedures are performed for spinal stenosis or axial back pain. In select patients, strategic use of epidurals should be considered.