scholarly journals Cost effectiveness of epidural steroid injections to manage chronic lower back pain

2012 ◽  
Vol 12 (1) ◽  
Author(s):  
David K Whynes ◽  
Robert A McCahon ◽  
Andrew Ravenscroft ◽  
Jonathan Hardman
Keyword(s):  
Back Pain ◽  
Cost Effectiveness ◽  
Lower Back Pain ◽  
Chronic Lower Back Pain ◽  
Steroid Injections ◽  
Epidural Steroid Injections ◽  
Lower Back ◽  
Epidural Steroid

scholarly journals Understanding whether chronic lower back pain patients with lumbar spinal stenosis benefit from multiple epidural steroid injections prior to the mild® Procedure

2021 ◽  
Author(s):  
Peter Pryzbylkowski ◽  
Anjum Bux ◽  
Kailash Chandwani ◽  
Vishal Khemlani ◽  
Shawn Puri ◽  
...  
Keyword(s):  
Back Pain ◽  
Treatment Process ◽  
Steroid Injection ◽  
Epidural Steroid Injection ◽  
Chronic Lower Back Pain ◽  
Steroid Injections ◽  
Epidural Steroid Injections ◽  
Lower Back ◽  
Lumbar Spinal ◽  
Epidural Steroid

Originally published in Pain Management, this article is a summary of a study performed to look at the benefit, if any, of more than one epidural steroid injection in the spine before the mild® Procedure. Minimally invasive lumbar decompression (commonly known as the mild Procedure) and epidural steroid injections are both common treatment options for lumbar spinal stenosis (commonly referred to as LSS), a condition that causes chronic lower back pain in older adults. To determine how to best treat LSS patients, healthcare professionals use a guide to help with the decision-making process (called an algorithm) to pass through non-medical to more invasive therapies that often includes one or more epidural steroid injections. An epidural steroid injection is medication inserted in the lower back to reduce swelling and provide relief from pain. Researchers wanted to look at a change to when in the treatment process the mild Procedure is carried out. In the study, researchers compared the medical records of participants who had received either just one or no steroid injection prior to the mild Procedure, to participants who received two or more epidural steroid injections prior to the mild Procedure. Similar outcomes in both treatment groups in this study proved that giving more than one epidural steroid injection prior to the mild Procedure did not improve how well patients did and may have delayed patient care. Based on the results of the study, it is recommended that the standard treatment process for LSS patients be changed to give the mild Procedure either as soon as LSS is diagnosed or after the failure of the first epidural steroid injection.

scholarly journals Conus Medullaris Syndrome Days After A Single Epidural Steroid Injection

2020 ◽  
pp. 1-2
Author(s):  
Rafid Kasir ◽  
◽  
Jad Khalil ◽  
Keyword(s):  
Steroid Injection ◽  
Cauda Equina ◽  
Conus Medullaris ◽  
Epidural Steroid Injection ◽  
Chronic Lower Back Pain ◽  
Unique Case ◽  
Steroid Injections ◽  
Epidural Steroid Injections ◽  
Lower Back ◽  
Epidural Steroid

Background: Epidural steroid injections (ESI) are commonly used in treatment of chronic lower back pain. Conus medullaris and cauda equina syndromes are rare complications of ESI. However, these typically occur after multiple injections within a few minutes to hours. Some reported cases are also transient, with patients completely regaining neurological function. We discuss a unique case of a patient developing conus medullaris syndrome over 24 hours after a single epidural steroid injection without resolution of symptoms.

scholarly journals Study protocol randomised controlled trial comparison of cost–utility and cost-effectiveness of a face-to-face rehabilitation programme versus a telemedicine programme in the treatment of patients with chronic low back pain

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040633
Author(s):  
Adelaida M Castro-Sanchez ◽  
Guillermo Adolfo Matarán-Peñarrocha ◽  
Silvia Gómez-García ◽  
Héctor García-López ◽  
Lazaro Andronis ◽  
...  
Keyword(s):  
Back Pain ◽  
Cost Effectiveness ◽  
Health Service ◽  
Lower Back Pain ◽  
Controlled Trial ◽  
Cost Utility ◽  
Chronic Lower Back Pain ◽  
Face To Face ◽  
Lower Back ◽  
Mckenzie Method

IntroductionChronic lower back pain is a highly prevalent medical condition in Western countries, which that incurs a considerable social and economic burden. Although prescription exercise at home for chronic pain has become a widely used alternative to reduce healthcare costs, the evidence regarding patient adherence and decreased in costs in European countries is scarce and inconclusive. The objective of this study is to examine the cost–utility and cost-effectiveness in patients with chronic lower back pain treated with the McKenzie Method and electroanalgesia via a telemedicine programme versus a face-to-face programme.Methods and analysisThis study reports the protocol for a randomised, two-arm, multicentre, parallel controlled trial. A total of 540 patients with chronic lower back pain (onset time ≥3 months, Roland Morris Disability Questionnaire ≥4) will be recruited in three hospitals in Andalusia. Participants will be assigned to one of two groups (n=270, respectively) to receive electroanalgesia and Mckenzie method exercises through a telemedicine or a face-to-face programme. A total of 24 sessions will be administered three times a week for 8 weeks. Since the study design does not allow participant blinding, the outcome assessor and the statistician will be blinded. Use of helth care resources and costs due to work absenteeism will be captured and analysed. In addition, pain, intensity, fear of movement, quality of life and strength of the core muscle and anteflexion lumbar will be recorded at 2 and 6 months after the start of treatment.Ethics and disseminationHuman Research and Local Ethics Committee of the ‘Hospital Complex Torrecárdenas of Almeria, University Hospital of Granada and Virgen Macarena de Sevilla Hospital—Andalusian Health Service’. Study findings will be released to the research, clinical and health service through publication in international journals and conferences.Trial registration numberNCT04266366.

scholarly journals Changes in Bone Mineral Density in Postmenopausal Women Treated with Epidural Steroid Injections for Lower Back Pain

2012 ◽  
Vol 3;15 (3;5) ◽  
pp. 229-236
Author(s):  
Byeong-mun Hwang
Keyword(s):  
Bone Mineral Density ◽  
Back Pain ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Lower Back Pain ◽  
Mineral Density ◽  
Epidural Steroid Injections ◽  
Lower Back ◽  
One Year ◽  
Epidural Steroid

Background: Therapy with corticosteroids often results in bone loss and corticosteroid-induced osteoporosis. In previous studies, bone mineral density (BMD) has been examined after administration of relatively high oral doses of corticosteroids. However, practitioners use comparatively lower doses of corticosteroids for epidural steroid injections (ESI). The interactions and relationships between BMD and ESI remain to be determined. Objective: The aim of this study was to explore the relationship between BMD and ESI in postmenopausal women treated for lower back pain. Study design: This study was a retrospective evaluation. Methods: We reviewed the medical records of postmenopausal women with lower back pain who were treated with or without ESI. BMD was measured before treatment and one year after treatment in the lumbar spine, femoral neck, and total femur. A total of 90 postmenopausal women were divided into 2 groups. Group 1 patients received medications without ESI; Group 2 patients received ESI more than 4 times, with a cumulative administered triamcinolone dose of > 120 mg. Results: Decreased BMD was observed in patients treated with ESI. However, no significant difference was observed between or within the groups in terms of mean percentage change from baseline BMD. Limitations: First, this study is limited by the fact that it was retrospective. Second, our study did not consider the use of ESI with high-dose corticosteroids. Third, our study did not include any long-term assessments of the effects of ESI on BMD. Conclusions: These data suggest that ESI using triamcinolone (over 200 mg) for a period of one year will have a negative effect on BMD in postmenopausal women treated for lower back pain. However, ESI therapy using a maximum cumulative triamcinolone dose of 200 mg in one year would be a safe treatment method with no significant impact on BMD. Key words: bone mineral density, corticosteroid, epidural steroid injection, lower back pain, postmenopausal women, triamcinolone.

scholarly journals Effects of Prolonged Sitting with Slumped Posture on Trunk Muscular Fatigue in Adolescents with and without Chronic Lower Back Pain

Medicina ◽  
2020 ◽  
Vol 57 (1) ◽  
pp. 3
Author(s):  
Kyoung-Sim Jung ◽  
Jin-Hwa Jung ◽  
Tae-Sung In ◽  
Hwi-Young Cho
Keyword(s):  
Back Pain ◽  
Lower Back Pain ◽  
Transversus Abdominis ◽  
Muscular Fatigue ◽  
Trunk Muscles ◽  
Control Group ◽  
Chronic Lower Back Pain ◽  
Median Frequency ◽  
Prolonged Sitting ◽  
Lower Back

Background and Objectives: This study investigated the effects of prolonged sitting on trunk muscular fatigue and discomfort in participants with and without chronic lower back pain (LBP). Material and Methods: This study included 15 patients with LBP and 15 healthy controls. All participants were instructed to sit on a height-adjustable chair with their knee and hip joints bent at 90° for 30 min, in slumped sitting postures. Surface electromyography was used to assess the median frequency of the internal obliques (IO)/transversus abdominis (TrA) and multifidus (MF) muscles. Perceived discomfort was measured using a Borg category ratio-scale. Median frequency of the trunk muscles and perceived discomfort after 30 min of sitting were compared with baseline. Result: There were no significant differences within the group and between both groups in the median frequency of bilateral IO and MF muscles. The LBP group showed significantly greater perceived discomfort after prolonged sitting, as compared to the control group. Conclusions: Prolonged sitting with slumped posture could increase the risk of experiencing lower back discomfort.

scholarly journals Therapeutic Effectiveness of AxioBionics Wearable Therapy Pain Management System in Patients with Chronic Lower Back Pain

2021 ◽  
Vol 14 ◽  
pp. 117954412199377
Author(s):  
Philip Muccio ◽  
Josh Schueller ◽  
Miriam van Emde Boas ◽  
Norm Howe ◽  
Edward Dabrowski ◽  
...  
Keyword(s):  
Back Pain ◽  
Pain Management ◽  
Lower Back Pain ◽  
Chronic Lower Back Pain ◽  
Analog Scale ◽  
System A ◽  
System Reduction ◽  
Lower Back ◽  
Muscular Function

Chronic lower back pain is one of the most common medical conditions leading to a significant decrease in quality of life. This study retrospectively analyzed whether the AxioBionics Wearable Therapy Pain Management (WTPM) System, a customized and wearable electrical stimulation device, alleviated chronic lower back pain, and improved muscular function. This study assessed self-reported pain levels using the visual analog scale before and during the use of the AxioBionics WTPM System when performing normal activities such as sitting, standing, and walking (n = 69). Results showed that both at-rest and activity-related pain were significantly reduced during treatment with the AxioBionics WTPM System (% reduction in pain: 64% and 60%, respectively; P < .05). Thus, this study suggests that the AxioBionics WTPM System is efficacious in treating chronic lower back pain even when other therapies have failed to sufficiently decrease reported pain levels.

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