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
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| 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
American Society of Pain and Neuroscience