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Evidence statementsEvidence to recommendations

A SR identified a RCT that met the inclusion criteria. It showed that facet-joint corticosteroid injections were not associated with any improvement in health outcomes at 1 month, and with improvement in pain at 6 months (however, the effect was reduced when concurrent interventions were taken into account). Overall conclusion was that facet-joint injections were of little value.(1+)(Boswell, Mark, V, Colson, James D., Sehgal, Nalini et al, 2007).

One systematic review on prolotherapy found no effect on pain, disability or well being for patients with chronic low back pain(1++) (Dagenais, S., Yelland, M. J., Del Mar, C. et al, 2007)

One RCT did not find any effect of intradiscal corticosteroid injections on the health outcomes of interest, compared to saline injections (1+)(Khot, Abhay, Bowditch, Mark, Powell, John et al, 2004)

No cost effectiveness studies were identified for injections or nerve blocks

Searches were carried out to identify any form of injection for the lower back, however, only data on facet-joint, prolotherapy and intradiscal injections was identified.
The GDG agreed that there was a lack of evidence to recommend the use of these treatments and agreed by consensus injections were of no benefit for this population-.

From: 9, Invasive Procedures

Cover of Low Back Pain
Low Back Pain: Early Management of Persistent Non-specific Low Back Pain [Internet].
NICE Clinical Guidelines, No. 88.
National Collaborating Centre for Primary Care (UK).
Copyright © 2009, Royal College of General Practitioners.

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