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Epidurals or Physical Therapy? ELDOA exercises Los Angeles

The goal of epidural injections and surgery is to provide pain relief. The goal of shockwave therapy (Zimmer, Storz, Piezowave), Magnet therapy (Magnawave), and laser therapy (TheraLase, LightForce) is to provide a healing environment inside the body leading to pain relief. Epidural injections do not heal a bad back. Shockwave, laser, magnet therapy, exercise and hands-on therapy will help heal a bad back.

Some patients do get epidural steroid injections and find short-term pain relief. Often times this sense of immediate pain relief prevents people from getting the proper treatment for his/her long term back pain care.

A study from Vanderbilt University discusses the use of epidural injection treatments and spinal surgery:
…surgery is superior to epidural steroid injections for improving quality of life and pain, however after a year neither the surgery or the epidural steroid injections significantly helped improve the patient’s disability.(1)

Johns Hopkins School of Medicine, Walter Reed National Military Medical Center, University of Toronto researchers describe:
Epidural steroid injections provide modest pain relief up to 3 months in patients with lumbosacral radicular pain caused by herniated disks, but they have no impact on physical disability or incidence of surgery.(2)

The Chinese University and Prince of Wales Hospital in Hong Kong: …transforaminal epidural steroid injection cannot alter the need for surgery in the long term.(3)

Department of Orthopedic Surgery, Thomas Jefferson University, Rothman Institute:
For some patients epidural steroid injections did not work at all. “Patients with lumbar disc herniation treated with epidural steroid injection had no improvement in short or long-term outcomes compared with patients who were not treated with epidural steroid injection.” (4)

THE PROBLEM you as a patient face: Epidural steroid injections are still one of the most frequently performed low back pain procedures. BUT, epidural steroid injections really should be questioned for lack of effectiveness, and may be dangerous.
Patients need to know that they have alternatives. Rather than exposing patients to risks from injections and dangerous complications, I start low back treatment with non-invasive shockwave, laser, or magnet therapy, combined with skilled hands-on therapy and ELDOA exercise training. (5) Doesn’t this make sense?

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1 Sivaganesan A, Chotai S, Parker SL, McGirt MJ, Devin CJ. 161?Patient-Reported Outcomes After Epidural Steroid Injections vs Surgery for Degenerative Lumbar Disease: A Prospective, Matched Cohort Study. Neurosurgery. 2016 Aug;63 Suppl 1:164-5. doi: 10.1227/01.neu.0000489730.99853.c3.
2. Bhatia A, Flamer D, Shah PS, Cohen SP. Transforaminal Epidural Steroid Injections for Treating Lumbosacral Radicular Pain from Herniated Intervertebral Discs: A Systematic Review and Meta-Analysis. Anesth Analg. 2016 Mar;122(3):857-70. doi: 10.1213/ANE.0000000000001155.
3. Leung SM, et al. Clinical value of transforaminal epidural steroid injection in lumbar radiculopathy. Hong Kong Med J. 2015 Aug 14. doi: 10.12809/hkmj144310. [Epub ahead of print]
4. Radcliff K, Hilibrand A, Lurie JD, Tosteson TD, Delasotta L, Rihn J, Zhao W, Vaccaro A, Albert TJ, Weinstein JN. The Impact of Epidural Steroid Injections on the Outcomes of Patients Treated for Lumbar Disc Herniation: A Subgroup Analysis of the SPORT Trial J Bone Joint Surg Am. 2012 Jun 27. doi: 10.2106/JBJS.K.00341. [Epub ahead of print]
5. Epstein NE The risks of epidural and transforaminal steroid injections in the Spine: Commentary and a comprehensive review of the literature Spine: 2013;3:74-93 6. Stout A. Epidural steroid injections for low back pain. Phys Med Rehabil Clin N Am. 2010 Nov;21(4):825-34.

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