Time to reconsider steroid injections in the spine?

Glucocorticoid (often simply called ?steroid?) injections into the spine, a procedure frequently performed by specialist radiologists using imaging for localisation, are increasingly being used to treat non-specifi c low back pain or leg (radicular) pain due to disc herniation or spinal stenosis. A report from the United States shows a sixfold increase in Medicare expenditure for epidural steroid injections in the 7 years up to 2001.1 Similarly, an increased number of spinal steroid injections are being given each year in Australia. For example, the number of procedures that have been performed under the Medicare Benefi ts Schedule item 39013, which includes injection into one or more facet joints under image intensifi cation, has more than doubled in the 10 years to 2011, with over 31 500 provided in 2011 and over 35 000 in 2012.2