Injections for lower back pain and sciatica

New jab now available to alleviate the misery of back pain” might suggest that the millions of back pain sufferers were about to benefit enormously.  However, the devil is always in the detail… The injection of Cimzia talked about in the Daily Express article is only licensed for those with inflammatory disorders of the spine; that’s specific kinds of arthritis.  That brings the potential beneficiaries of this injection down to a very small proportion of back pain sufferers.  Probably not you. 🙁

What about other jabs?  Do they work?  It depends….  First you need to work out what kind of lower back problem or sciatica you have.  I’ve lots of other articles on types of lower back pain and sciatica, so check them out.  As ever, the info and advice we give is based on the latest scientific evidence.

The National Institute for Health and Care Excellence (NICE) advise NOT using any kind of injections for “non-specific lower back pain”.  However, in their response to NICE, the British Pain Society indicated flaws in the NICE guideline (don’t you love an argument), and pointed out that the NICE guideline was doing a disservice to a few lower back pain sufferers who may benefit.  Essentially they accused NICE of getting their statistics wrong.  Unfortunately, as Mark Twain credited Disraeli as saying “there are 3 kinds of lies: lies, damned lies, and statistics”.

If you have “non-specific” lower back pain of more than 4 weeks duration (termed “subacute” in this research) or more than 3 months (“chronic”), Staal et al (2009) concluded “Based on the current state of the literature there is insufficient evidence to support or refute the use of injection therapy, regardless of type and dosage, for patients with subacute and chronic low back pain” (excluding those with nerve irritation).  This review of the evidence was not included in the NICE guideline.  Note that the authors said they could not refute the use of injection therapy; a different stance to NICE.

But on a more hopeful note… epidural injection of steroids for those with definite nerve root irritation/inflammation – usually caused by disc problems are accepted by NICE as a valid short-term treatment (no guarantees given!).  Just make sure the person giving you the injection isn’t wired, and injecting tomato juice rather than the appropriate drug – unlike the guy in the image. 😉

As ever, if you’d like to discuss your options, please give me a ring or email


Staal, J.B., de Bie, R.A., de Vet, H.C.W., Hildebrandt, J., Nelemans, P., 2009. Injection Therapy for Subacute and Chronic Low Back Pain: An Updated Cochrane Review. Spine January 1, 2009 34, 49–59.
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