Patients suffering from low back pain for several years have been relieved by the infiltration of corticosteroids. An effect, however, limited in time.
Corticosteroid infiltrations directly into the intervertebral discs relieve chronic low back pain for a month, reports a study conducted at the Cochin hospital (Assistance Publique – Hôpitaux de Paris) and published in Annals of Internal Medicine.
In France, around 5 million people suffer from low back pain, 20% of which is from the intervertebral disc. To treat this chronic pain, it is currently recommended to prescribe patients rest, rehabilitation sessions with physiotherapists as well as anti-inflammatory drugs, such as ibuprofen. Support that does not always alleviate the pain.
But to believe the results presented by the team of Professors Serge Poiraudeau and François Rannou, from the rehabilitation-rehabilitation service of the musculoskeletal system and spinal pathologies at Cochin hospital, corticosteroids are an interesting alternative, for some people. patients.
Time-limited effect
This study, conducted in Paris, involved 135 patients aged 46 on average and suffering from low back pain for several years. They all presented with disc disease, which is inflammation of the intervertebral discs. 67 received an injection of corticosteroids, while the 68 patients in the control group were injected with physiological saline as a placebo. This study shows that corticosteroid infiltration significantly relieves patients during the first month.
However, the results suggest a rebound in pain after 3 months in some patients. And a year after the injection, the intensity of low back pain returns to its original level, forcing patients to resort to nonsteroidal anti-inflammatory drugs.
Stem cells under study
For the time being, this transient effect is one of the main limits to the use of this treatment in practice by doctors. Thus, “the next challenge lies in a new test aimed at obtaining a long-term symptomatic effect and may be structural on disc disease, this is the subject of a European H2020 trial which is beginning”, explains Professor François Rannou, one of the works managers.
Francois Rannou, rheumatologist at Cochin University Hospital: ” Obviously, an infiltration is not sufficient. One solution is to make several infiltrations … “
To relieve patients in the longer term, it is necessary to “cleanse the inflammation”, specifies the doctor. And for this, the team also relies on stem cells. Doctors have already started a protocol, in collaboration with colleagues from Montpellier, which aims to inject cells into the damaged disc. The idea is to use “the anti-inflammatory effect and not the regenerator of stem cells”, underlines Professor Rannou.
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