Interventional Treatments for Low Back Pain

Publication Date: December 6, 2022
Last Updated: December 12, 2022

Summary of Recommendations

Epidural Steroid Injections

Recommendation Grade Level Level of certainty
Interlaminar epidural injections for treatment of low back and radicular pain originating from disc disease, spinal stenosis and for chronic back/leg pain after surgical intervention A I-A High
Transforaminal epidural injections for treatment of low back and radicular pain originating from disc disease, spinal stenosis and for chronic back/leg pain after surgical intervention A I-A High
Caudal epidural injections for treatment of low back and radicular pain originating from disc disease, spinal stenosis and for chronic back/leg pain after surgical intervention when interlaminar or transforaminal approaches are not feasible A I-A High
Use of either steroid or local anesthetic or the two classes of medication in combination for use in epidural injections for treatment of low back and radicular pain originating from disc disease, spinal stenosis and for chronic back/leg pain after surgical intervention A I-A High

Tables

Disease Indications for Intrathecal Drug Delivery

Having trouble viewing table?
Axial neck or back pain (not a surgical candidate)
- Multiple compression fractures
- Discogenic pain
- Spinal stenosis
- Diffuse multiple-level spondylosis
Failed back surgery syndrome/Post-laminectomy syndrome
Trunk pain
- Postherpetic neuralgia
- Post-thoracotomy syndromes
Abdominal/pelvic pain
- Visceral
- Somatic
Extremity pain
- Radicular
- Joint
Complex regional pain syndrome (CRPS)
Cancer pain, primary invasion, metastasis, and treatment (chemotherapy, radiation)-related
Analgesic efficacy with systemic opioid delivery complicated by intolerable side effects

Overview

Title

Interventional Treatments for Low Back Pain

Authoring Organization