'Spinal injections effective for leg pain in diabetic patients'

A research team at Seoul National University Bundang Hospital (SNUBH) has found that diabetic patients suffering from leg pain can benefit from spinal injections to the same extent as non-diabetic patients, challenging long-held concerns that the treatment is less effective or riskier in this population.

The study, led by Professors Kim Young-june and Lee Joon-woo of the Department of Radiology at SNUBH, evaluated 218 patients who underwent spinal injections at the hospital for leg pain. The researchers compared pain reduction and side effect rates between diabetic and non-diabetic patients. Contrary to widespread assumptions, the study confirmed no statistically significant difference in pain relief or complication rates between the two groups.

Spinal injections, also known as epidural steroid injections, are commonly used to treat leg pain caused by spinal conditions such as herniated discs or spinal stenosis.

In diabetic patients, however, physicians have been cautious due to overlapping symptoms with diabetic neuropathy, temporary blood sugar elevations linked to steroids, and reports suggesting higher infection risks. As a result, many patients avoided treatment, leaving spinal conditions untreated.

“Our study shows that diabetic patients should not automatically be excluded from spinal injection therapy out of fear of poor outcomes,” Professor Kim said. “Too often, patients delay treatment due to concerns over blood sugar or infection, but with careful monitoring, spinal injections can be an important treatment option.”

The research also highlighted important limitations. Spinal injections were less effective in patients with chronic pain lasting more than six months or in those with only mild pain, even when imaging confirmed spinal abnormalities. In such cases, diabetic neuropathy rather than spinal disease may be the underlying cause, underscoring the need for precise diagnosis.

“Not all diabetic patients with leg pain are candidates for spinal injections,” Professor Lee said. “It is essential to carefully assess pain duration, severity, and whether the source is a spinal disorder or diabetic neuropathy before deciding on treatment.”

The authors emphasized that their findings provide clearer clinical guidelines for managing leg pain in diabetic patients, offering reassurance to both physicians and patients. They expect the results to support earlier intervention and more effective treatment strategies for the growing number of patients facing both diabetes and spinal disease.

The results of the research were published in Skeletal Radiology.