Researchers Call for More Studies on the Use of Steroids to Treat Pinched Nerves

Stanford University researchers recently conducted a systematic review of studies on cervical radiculopathy, commonly referred to as “pinched nerve,” to determine if steroids are a safe and effective treatment. 

Cervical radiculopathy is a rare but often disabling disease that is commonly relieved by pain and disability management. It is caused by compression of nerve roots in the neck, which leads to pain, weakness, or numbness. Only about 25% of cases require surgery. Physicians often start the treatment plan with oral steroids before moving on to cervical epidural steroid injections, which may have limited benefit and can lead to serious complications.

The researchers conducted their review by searching for existing studies via electronic databases. After accounting for duplicates and studies that did not cover the required area, only seven studies looked at the use of steroids for this condition – 6 studied oral steroids and 1 studied intramuscular steroids. Results were limited; however, no adverse events were reported.

“Our systematic review demonstrated that few studies have been published to evaluate the effectiveness of systemic steroids in the treatment of cervical radicular pain,” explained investigator Cyrus Ghaffari, MD. “Based on one moderate-quality study, oral steroids are more effective than placebo. Based on one low-quality study, intramuscular steroids are less effective than epidural steroid injections.”

The team concluded that additional high-quality studies are needed to evaluate this modality for treating cervical radicular pain. 

“Systemic Steroids for Cervical Radicular Pain: A Systematic Review,” was conducted by Nolan Gall, MD, Cyrus Ghaffari, MD, Jyotsna Koduri, MD, Christopher Dove, MD, and Josh Levin, MD, who work in the department of orthopedic surgery at Stanford University. Dr. Levin additionally works in the department of neurosurgery. This study received one of three Resident/Fellow Travel Awards from ASRA Pain Medicine and will be presented at the 21st Annual Pain Medicine Meeting in a session on Friday, November 18, at 10:30 am ET, at the Hilton Bonnet Creek in Orlando, FL.

ASRA Pain Medicine is a membership society of more than 5,000 healthcare professionals devoted to advancing evidence-based practice of pain medicine across the pain continuum, from acute pain to chronic pain. Our mission is to advance the science and practice of regional anesthesia and pain medicine to improve patient outcomes through research, education, and advocacy. Our vision is to relieve the global burden of pain. We are committed to integrity, innovation, inclusiveness, service, compassion, and wellness. Learn more at www.asra.com.