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Papers of the Week

2020 Aug

Pain Physician



Steroid Distancing in Interventional Pain Management During COVID-19 and Beyond: Safe, Effective and Practical Approach.


Manchikanti L, Kosanovic R, Vanaparthy R, Vangala B P, Soin A, Sachdeva H, Shah S, Knezevic N N, Hirsch JA
Pain Physician. 2020 Aug; 23(4S):S319-S350.
PMID: 32942792.


Since the late 1940s, corticosteroids have been a mainstay class of agents in multiple interventional techniques and intra-articular injections. Exogenous glucocorticoids are structurally and pharmacologically similar to the endogenous hormones. As such, multiple actions of corticosteroids are exhibited, including those of anti-inflammatory and immunosuppressive effects. Epidural injections, with or without steroids, have been extensively used throughout the world. There are reports of epidural injections starting in 1901, with steroids being added to the local anesthetic since 1952, when steroids were administered into the sacral foramen.