While medical histories are almost as unique as our fingerprints, perhaps one of the most common ailments that affects people all over the world is lower back pain.

Remedies abound, including epidural steroid injections into the spine, also called ESI. These shots appear to work about 60 percent of the time in reducing inflammation, thereby relieving the pain. But the long-term effectiveness of such shots have been in question for years. The side effects have also been concerns. They include bone disease in older women and slower wound healing in all patients. And those apprehensions were raised dramatically about a year ago when more than 50 people died, and another 700 became seriously ill with fungal meningitis after receiving compounded epidural steroid injections prescribed for lower back pain.

These issues prompted researchers at The John Hopkins University to review more than 40 studies that looked at the records of over 3,600 patients, all of whom suffered from lower back pain. The investigations they analyzed were those where several alternative epidural and intramuscular injections were compared to the effectiveness of steroids in relieving the patients’ pain.

Their findings showed that the steroids worked better than alternatives when injected into muscle near the spine. But they also discovered that when any shot, including saline, was delivered into the spine, that worked twice as well at reducing back pain as the steroids injected into muscle tissue. This left researchers to conclude that perhaps it is just the action of having a liquid introduced into the spine that alleviates the pain.

Further tests are clearly warranted, but this research could help pave the way to new treatments for a global health problem.