Managing chronic low back pain (LBP) in older adults requires balancing treatment efficacy with patient safety. Consequently, **epidural steroid injections** (LESI) have emerged as a significant interventional strategy. While global health guidelines emphasize conservative therapies, researchers are increasingly evaluating the role of injections for this specific demographic.

Benefits of Epidural Steroid Injections in Older Patients

A recent systematic review analyzed 12 studies focusing on older patients with low back pain. The results consistently showed that LESI treatments lead to significant improvements in pain scores. Additionally, patients reported a better quality of life and improved functional status following the procedure. Therefore, these injections provide a robust alternative for those who do not find relief through oral medications.

Comparing LESI with Medication and Physical Therapy

In the clinical comparison, **epidural steroid injections** proved superior to standard medication management for pain reduction. Interestingly, the study also found that adding physical therapy to the injection regimen did not yield better results than LESI alone. This suggests that the injection itself serves as the primary driver for functional improvement. However, clinicians should still personalize care based on individual patient needs and comorbidities.

Conclusion for Clinical Practice

This review represents the first systematic effort to quantify LESI effectiveness specifically for the geriatric population. The evidence suggests that these interventions effectively bridge the gap between conservative management and invasive surgery. Consequently, integrating these injections into pain management protocols may help reduce the disability burden in older adults.

Frequently Asked Questions

Are epidural steroid injections better than medication for the elderly?

Yes, research indicates that these injections are associated with statistically significant improvements in both pain and functional status when compared to standard medication management.

Is physical therapy required alongside these injections?

While physical therapy is often recommended for low back pain, this review found that adding it to an injection regimen was not superior to using the injection alone.

Disclaimer: This content is for informational and educational purposes only. It does not constitute medical advice or a professional relationship. Refer to the latest local and national guidelines for clinical practice.

References

Zhu AC et al. Effectiveness of epidural steroid injections for low back pain in older adults: a systematic review. Aging Clin Exp Res. 2026 Feb 07. doi: 10.1007/s40520-026-03336-0. PMID: 41653389.

Chou R, Hashimoto R, Friedly J, et al. Epidural Corticosteroid Injections for Radiculopathy and Spinal Stenosis: A Systematic Review and Meta-analysis. Ann Intern Med. 2015;163(5):373-381.

Oliveira CB, Maher CG, Pinto RZ, et al. Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview. Eur Spine J. 2018;27(11):2791-2803.