The RCGP - Clinical and Special Projects, Clinical Guidelines, Acute Low Back Pain. Contents, Index page
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Chapter 2

Evidence Review

Physical Therapies


Back exercises

Physical Agents and Modalities


Transcutaneous Electrical Nerve Stimulation (TENS)

Shoe Insoles and Shoe Lifts

Lumbar Corsets and Supports

Trigger Point and Ligamentous Injections


Epidural Steroid Injections

Facet Joint Injections


Group education: back school

Epidural Steroid Injections

There are now 12 RCTs of epidural steroid injections, many of which are of reasonable quality.

Epidural injections of steroids with or without local anaesthetic appear to produce better short-term relief of acute low back pain with sciatica than the treatments to which they have been compared.

Koes et al 1995b

Limited evidence suggests that epidural injections of steroids, local anesthetics, and/or opioids lack proven efficacy for acute low back pain without radiculopathy. (D)
Epidural injections are invasive and pose rare but serious potential risks. (B)


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