Epidural Injections for Long Term Pain Relief in Lumbar Spinal Stenosis.

CLINICAL QUESTION: In adults with lumbar spinal stenosis, do epidural injections (anesthetics with or without steroids) provide long term improvement in pain and functionality? ANSWER: Yes.Studies show that anesthetic epidural injections provide long term and short term improvement in pain and functionality in patients with lumbar spinal stenosis. Studies do not show good evidence addition of steroids can add any benefit in the improvement in pain and functionality. LEVEL OF EVIDENCE OF THE ANSWER: A. SEARCH TERMS: Lumbar spinal stenosis, long term, pain, epidural injections. LIMITS: Adult, human, English, Review, Randomized-Control Trials, Systematic Reviews, meta-analysis, adults age 18 or more, publication dates 2015 to now. DATE SEARCH WAS CONDUCTED: October 13, 2018. INCLUSION AND EXCLUSIONS CRITERIA: Inclusion Criteria:Recent published systematic reviews, randomized controlled trials, meta-analyses; adults with lumbar spinal stenosis, treatment with epidural injections. EXCLUSION CRITERIA: Studies older than 5 years, children, adolescents less than 18 years of age, just lower back pain or radiculopathy but not specifically spinal stenosis.