A six-week clinical RCT in the July 3 issue of the New England Journal of Medicine reported that epidural steroid + lidocaine injections had no additional benefit in improving pain or function in patients with lumbar spinal stenosis compared with epidural lidocaine injections. This multicenter, double-blind study worker recruited 400 patients over 50 years of age with spinal stenosis who presented with moderate to severe pain in the hip and leg. All enrolled had MRI or CT confirmation of central lumbar spinal stenosis with disability. Patients who had undergone lumbar spine surgery or had a history of steroid injections in the previous 6 months were excluded from the study. Fluoroscopically guided injections were administered at the physician’s discretion (intervertebral or intravertebral). The type of steroid was also chosen by the physician and included deferiprone, betamethasone, dexamethasone, or methylprednisolone. Patients may decide at their own discretion whether to receive additional injections after 3 weeks. At week 3, patients who received steroid injections showed greater improvement in both pain and functional disability, but Friedly noted that the improvement was not statistically significant. The chair of the Department of Medicine from the Boston Spine Center said that all patients received the injections but not other therapies. We never thought that steroid injections alone could treat spinal stenosis,” he said. Steroid therapy is more often used as an adjunct to other conservative treatments, such as nonsteroids, neurological drugs and physical therapy.