I only got as far as the first paragraph when warning bells started ringing.

"...patients who received epidural steroid injections (ESI) had a higher rate of crossover to surgery and fared worse in physical health and bodily pain versus those who did not receive ESI..."

What that says to me is that patients who have ESI do so because they experience more pain, and that being the case, are more likely to elect surgery even if they are assigned to non-surgical courses of treatment.

"At the onset of our study, we hypothesized that patients who received ESI would have improved outcomes and lower rates of surgery compared to patients who did not receive ESI,"

- why, for God's sake? Why would you think that patients in the most pain should have the best outcomes?

"...the group of patients who received ESI had significantly less improvement and no evidence of surgical avoidance," - because ESI is temporay pain management, not a cure, you dipshits!

Please tell me what I am missing, or I will continue to despair about the declining quality of cognitive function in the research community and medical profession.