Lumbar epidural steroid injections are commonly performed in the United States for treating radicular low back pain. However, the best available data suggest that the benefit afforded by these injections is quite limited; in fact, new data suggest that in geographic areas where many such injections are performed, more and not fewer spine surgeries are actually completed annually. We suggest that further high-quality studies are required and their results respected through their implementation in daily practice to better ensure that only appropriate patients are advised to undergo this procedure.