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Time to reconsider steroid injections in the spine?

Nikolai Bogduk
Med J Aust 2013; 199 (11): . || doi: 10.5694/mja13.11077
Published online: 16 December 2013

To the Editor: In their review, Harris and Buchbinder call for a ban on all spinal injections of steroids.1 These injections are not a singular procedure; they differ by indications, technique, and the evidence that serves each.


  • Newcastle Bone and Joint Institute, Newcastle, NSW.


Correspondence: nbogduk@bigpond.net.au

Competing interests:

I am a Board member of the International Spine Intervention Society; while I am an exponent of the procedures in question, I derive no income from them.

  • 1. Harris IA, Buchbinder R. Time to reconsider steroid injections in the spine? Med J Aust 2013; 199: 237. <MJA full text>
  • 2. Bogduk N. A narrative review of intra-articular corticosteroid injections for low back pain. Pain Med 2005; 6: 287-296.
  • 3. Bogduk N. Pharmacological alternatives for the alleviation of back pain. Expert Opin Pharmacother 2004; 5: 2091-2098.
  • 4. Bogduk N. Epidural steroid injection. In: Fishman SM, Ballantyne JC, Rathmell JP, editors. Bonica’s management of pain. 4th ed. Philadelphia: Wolters Kluwer, 2010: 1423-1437.
  • 5. International Spine Intervention Society. Lumbar interlaminar epidural access. In: Bogduk N, editor. Practice guidelines for spinal diagnostic and treatment procedures. San Francisco: International Spine Intervention Society, 2013: 539-557.
  • 6. Price C, Arden N, Coglan L, Rogers P. Cost-effectiveness and safety of epidural steroids in the management of sciatica. Health Technol Assess 2005; 9: 1-74.
  • 7. Valat JP, Giraudeau B, Rozenberg S, et al. Epidural corticosteroid injections for sciatica: a randomised, double-blind, controlled clinical trial. Ann Rheum Dis 2003; 62: 639-643.
  • 8. Faculty of Pain Medicine, Australian and New Zealand College of Anaesthetists. PM03: Lumbar epidural administration of corticosteroids. 2002; Aug. http://www.anzca.edu.au/fpm/resources/professional-documents/documents/pm3 (accessed Nov 2013).
  • 9. Ghahreman A, Ferch R, Bogduk N. The efficacy of transforaminal injection of steroids for the treatment of lumbar radicular pain. Pain Med 2010; 11: 1149-1168.
  • 10. MacVicar J, King W, Landers M, Bogduk N. The effectiveness of lumbar transforaminal injection of steroids: a comprehensive review with systematic analysis of the published data. Pain Med 2013; 14: 14-48.

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