An editorial discusses the strengths and limitations of this study, highlighting that the authors followed the recommendations from the National Institute of Health, and reported categorical outcomes to appropriately account for responders and nonresponders. The editorial notes “With respect to the primary outcome, patients who received glucocorticoid intradiscal injection were more likely than those in the control group to achieve a pain score less than 40 on a numerical rating scale at 1 month. Despite this favorable finding, the authors tempered their conclusions, noting the lack of sustained benefit at 12 months in a secondary analysis.”
The author of the editorial notes that there are several considerations which need to be taken into account in interpretation of these results, including the heterogeneity of patients and pathologies complicating research on this condition. Whilst the authors appropriately set inclusion criteria which attempted to isolate patients with low back pain specifically associated with inflammation, the editorial comments on how this restriction may have affected the results suggesting a lack of sustained benefit at 12 months which is mentioned above.