Original Title: 만성 요통에 주사치료의 통증감소 효과

Authors' recommendations: In order to investigate the clinical effectiveness of injection therapy for low back pain, especially focusing on the long-term effects, the following studies were conducted: 1) a study on the current practice in Korea including comparison of the outcomes between the injection group and the non-injection group using the Health Insurance Review & Assessment service (HIRA) claims database from 2006 to 2008; and 2) a systematic review of existing randomized controlled trials. 1. Analysis of the current status The results showed that the number of patients with back pain had increased from 1.9 million to 2.2 million between 2006 and 2008. The annual medical expenditure for patients with back pain was 528.9 billion won in 2006, 581.8 billion won in 2007 and 608.4 billion won in 2008. The average period under treatment per patient showed a decrease from 10 days to 8 days from 2006 to 2008. The number of patients treated with injection therapy increased by 10.8-11.15% each year. The number of patients who were newly treated for back pain in 2006 was 880,000. The average annual medical expense per new patient was 199,172 won and patients received treatment for back pain for 6.6 days on average. After excluding patients who received surgery or opioid anesthesia within 6 months of the diagnosis, the number of patients who received injection therapy was 51,170 (5.8%) and the number of patients who did not receive injection therapy was 815,199 (92.4%). When these two groups' medical resources use for one year was compared, 1.0% of the injection group and 0.3% of the non-injection group underwent surgical intervention for back pain. The average medical expense per patient was 137,798 won for the injection group and 54,725 won for the non-injection group. The injection group was treated for 4.4 days, while the non-injection group received treatment for 2.0 days for their back pain. 2. Systematic review When considering the need for surgical intervention due to failure of injection therapy as the primary outcome, repeated epidural steroid injections did not show significant differences to non-invasive treatments, placebo treatments, and there were also no differences between injection treatments and other local anesthetic drugs or similar treatments. There were no significant differences in pain control after six or twelve months of the injection therapy compared to the control groups. After twelve months of follow-up, the pain control effect decreased even more in the injection group. After six months, there were no significant differences between the injection and the control groups, and after 12 months, disability due to low back pain tended to be worse in the injection group.

Project Status: Completed

Year Published: 2010

URL for published report: https://www.neca.re.kr/lay1/program/S1T11C145/report/view.do?seq=19

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: South Korea

Organisation Name: National Evidence-based healthcare Collaborating Agency

Contact Address: National Evidence-based Healthcare Collaborating Agency (NECA), 3~5F Health and Welfare Social Administration B/D, 400 Neungdong-ro, Gwangjin-gu, Seoul, Korea.

Contact Name: int@neca.re.kr

Contact Email: int@neca.re.kr

Copyright: National Evidence-based Healthcare Collaborating Agency (NECA)