Intradiscal Steroid Injections for Pain Management

This policy addresses intradiscal steroid (glucocorticoid) injections for management of presumed discogenic low back pain, including patients with MRI evidence of degenerative disc disease and positive discography and small subgroups with inflammatory endplate changes after failed epidural steroid injection. The policy considers intradiscal steroid injections not medically necessary because of limited and conflicting evidence and lack of sustained benefit at 12 months, notes potential harms (discitis, progression of disc degeneration, disc calcification), and does not support routine coverage.

"Intradiscal steroid injections are considered not medically necessary."

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