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Combination Therapy Improves Neck Pain, Finds Study

neck-painIt is estimated that more than two-thirds of adults will experience significant neck pain during their lifetime. Steroid injections are among the most commonly administered treatment for such pain.

A recent study funded by the Center for Rehabilitation Sciences Research reports that spinal steroid injections and conservative treatment combined with physical therapy and pain medications would work equally well to reduce chronic neck pain in the short term, but that over a period of time a combination of the two seems to offer the maximum relief.

The results of the study conducted by pain management specialists at the John Hopkins University School of Medicine were published in the Journal “Anesthesiology” dated October 21st, 2014. This is one of the largest studies ever done to evaluate the effectiveness of epidural steroid injections for chronic neck pain.

The study covered 169 men and women with a common form of neck pain. The primary objective was to compare the difference between steroid injections and conservative therapy and a combination of the two in this patient population. The patients, who were over age 18 and came from different backgrounds, suffered severe neck ache due to a herniated disc or spinal canal (stenosis) that inflamed or pinched nerves in their neck and caused pain that radiated to their arms. The participants were divided into 3 groups that reflected their treatment choices, namely, steroid injections, physical therapy and medications or a combination of both. The main findings of the study are as follows

  • After one month, no significant difference was noticed in outcomes between groups receiving different treatments. However, it was found that combination therapy offered better improvement than stand-alone treatment on some measures of pain.
  • Three months after the treatment, about 56.7 % patients who underwent combination therapy treatment experienced significant reduction in their pain and were fully satisfied with the treatment, when compared against 26.8 percent in the conservative therapy group and 36.7 percent in the group receiving injections alone.
  • The researchers concluded that combination therapy has become a cornerstone in rehabilitation medicine as injections provide only temporary relief and need to be combined with physical therapy.

The findings of this study suggest that epidural steroid injections should not be a first-line, stand-alone treatment for neck pain, but that the outcome can be improved with a multidisciplinary approach that combines these injections with exercise and physical therapy. The researchers have stressed that additional research would be necessary to determine why combination treatment was the most successful.

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