The researchers look at various factors such as which steroids were administered, amount of steroids used, and whether or not a local anesthetic was mixed with the steroid.

From News-Medical.Net:

“Epidural steroid injections are an important and common option for the treatment of back pain. However, we found that a great variety of techniques are being used. There is no gold standard,” said Dr. Patel, lead author of the study and resident at the University of California at San Diego. “Guidelines may need to be explored with regard to this procedure to increase the effectiveness and decrease risk when using this approach to treat pain.”

Dr. Patel’s study found there were differences from institution to institution regarding which steroid was preferred for these injections. The most common steroids identified for this procedure and respective dose ranges were: depomedrol (dose range 40-120 mg), celestone (dose range 6-15 mg), decadron (dose range 4-12 mg), and kenalog (dose range 10-80 mg).

“These variations in technique might affect why some patients get better results from ESI than others and may also explain good and poor outcomes. This needs to be explored further,” Patel concluded.

Yogesh Patel, MD, and his colleagues at UCSD, identified and surveyed attending pain physicians at the interventional pain programs in the United States for comparing currently implemented techniques. It was suggested that there is a lack of standard protocols with concern to type of steroid, use or dose of steroid.

Dr. Patel, lead author of the study and resident at the University of California at San Diego, was of the view that there was no gold standard for administering an epidural steroid injection for back pain.