Evidence-based review of steroid therapy for back pain

There are differences in the effectiveness, level of evidence and grade of recommendation for steroid use, associated or not with local anesthetics, according to the technique performed. Medial branch injection is more effective than facet joint injection. Epidural steroid injection is effective in back pain due to the different routes of access (interlaminar, transforaminal and caudal) when appropriately indicated and administered in well–selected patients. The most effective technique among those reviewed was intradiscal steroid injection. The authors recommend steroid administration as close as possible to the site of the lesion and the use of radiological vision to perform the distinct techniques, including epidural procedures.