63 studies on the efficacy of epidural corticosteroid injection for the treatment of spinal stenosis and/or radiculopathy were included in this meta-analysis. The purpose of the report was to produce a comprehensive assessment on the benefits and harms of epidural corticosteroid injection therapy. In radiculopathy, treatment with corticosteroids resulted in greater immediate pain relief and reduced short term risk of surgery compared to a placebo, but no lasting effects, difference in function, or difference in rate of successful outcome was observed. In spinal stenosis, corticosteroid treatment resulted in greater immediate pain relief compared to placebo, and greater short term functional improvement compared to local anaesthetic, but no other effects were observed. The risk of serious harm due to epidural corticosteroid injection was found to be low, but minor adverse events, such as bleeding or local hematoma, were commonly reported.