Spinal manipulation therapy (SMT) that uses compression on the spinal joints may also be a treatment consideration. A 2015 study published in the journal Spine found that this type of therapy works for some, but not all. Typically, SMT is performed by chiropractors and physical therapists. It has been controversial, with some medical experts claiming that it works, while others claim that it doesn't. "The big finding is that both sides have been right all along," said Greg Kawchuk, a professor of rehabilitation medicine at the University of Alberta and co-author of the study.
Although epidural steroid injections (also called epidural corticosteroid injections) may be helpful to confirm a diagnosis, they should be used primarily after a specific presumptive diagnosis has been established. Also, injections should not be used in isolation, but rather in conjunction with a program stressing muscle flexibility, strengthening, and functional restoration.
Proper follow-up after injections to assess the patient's treatment response and ability to progress in the rehabilitation program is essential. A limited number of injections can be tried to reduce pain, but careful monitoring of the response is required prior to a second or third injection.