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Evidence-Based Resource Summary

Strength of Evidence: 
4 out of 4
4 out of 4
Year Published: 

Cochrane Summary – Injection Therapy for Subacute and Chronic Back Pain

Description of Resource: 
Injection therapy is one of many treatments available for patients with subacute (longer than 6 weeks) and chronic (longer than 12 weeks) low-back pain. Where the injection is given, what drug is used, and why the injection is given can all vary. The review authors rated 10 of the 18 random clinical trials as having a low risk of bias in the way the trials were conducted and reported. They were unable to statistically pool the results because the injection sites, drugs used, and outcomes measured were too varied. Only 5 of the 18 trials reported significant results in favor of one of the treatment arms. The review authors considered the likely treatment benefits to be worth the potential harms in only 2 studies. In 9 out of the 18 studies, side effects such as headache, dizziness, transient local pain, tingling and numbness, and nausea were reported in small numbers of patients. The use of morphine was more frequently associated with itching, nausea, and vomiting. Rare but more serious complications of injection therapy have been mentioned in the literature such as cauda equina syndrome, septic facet joint arthritis, discitis, paraplegia, and paraspinal abscesses. Although the absolute frequency of these complications may be rare, these risks should be taken into consideration. Based on these results, the review authors concluded that there is no strong evidence for or against the use of any type of injection therapy for individuals with subacute or chronic low-back pain.

Evidence-Based Resource Details

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Developed By: 
Cochrane Collaboration
Developer Type: 
Non-Federal Government
Healthy People 2020 Topic Area(s): 
Arthritis, Osteoporosis, and Chronic Back Conditions
Healthy People 2020 Objectives: 
Resource Type: 
Systematic Review
Staal JB, de Bie R, de Vet HCW, Hildebrandt J, Nelemans P. Injection therapy for subacute and chronic low-back pain. Cochrane Database of Systematic Reviews [Internet]. 2011 Feb 16 [cited 2013 Feb 28]. Available from: