scholarly journals Ultrasound-guided caudal epidural steroid injection in chronic radicular low back pain: short-term electrophysiologic benefits

BJR|Open ◽  
2020 ◽  
Vol 2 (1) ◽  
pp. 20190006
Author(s):  
Maha Emad Ibrahim ◽  
Magdy Ahmed Awadalla ◽  
Aziza Sayed Omar ◽  
Mohammad al-Shatouri
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Control Group ◽  
Low Back ◽  
Ultrasound Guided ◽  
Analog Scale ◽  
Short Term ◽  
F Wave ◽  
Epidural Steroid ◽  
Caudal Epidural

Objective: To assess the short-term efficacy of ultrasound-guided caudal epidural steroid injections (ESIs) in improving pain, and nerve function as measured by electrophysiological testing in chronic radicular low back pain. Methods: Patients diagnosed with chronic radicular low back pain were randomized into one of two groups. The injection group (n = 20) underwent a single ultrasound-guided Caudal ESI of 1 ml of 40 mg ml−1 Triamcinolone Acetonide (Kenacort-A), with local anesthetic. The control group (n = 20) underwent a 12-session physiotherapy program. Both groups were evaluated before and 2 weeks after the intervention using visual analog scale for pain and electrophysiological testing comprising peroneal and tibial terminal motor latencies and F-response latencies and chronodispersion. Results: Both groups showed significant pain reduction on the visual analog scale after the intervention. The injection group showed a significant reduction in F wave chronodispersion post-treatment (<0.01). In the control group, there were no significant differences in F wave parameters pre- and post-treatment (p > 0.05). Conclusion: Caudal ESIs were shown to provide short-term improvement of nerve function as evident by improvement in the electrophysiological parameters sensitive to radiculopathy. It was found to be superior to standard physical therapy in this regard. Advances in knowledge: This work shows a novel electrophysiologic evidence of the short-term efficacy ultrasound-guided caudal ESI.

Efficacy and safety of ultrasound-guided caudal epidural steroid injection in patients with low back pain and sciatica

2021 ◽  
pp. 1-6
Author(s):  
Kasisin Klunklin ◽  
Apiruk Sangsin ◽  
Taninnit Leerapun
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Conservative Treatment ◽  
Steroid Injection ◽  
Epidural Steroid Injection ◽  
Post Injection ◽  
Low Back ◽  
Ultrasound Guided ◽  
Epidural Steroid ◽  
Caudal Epidural

BACKGROUND: Fluoroscopy-guided caudal epidural steroid injection (EDSI) is an option for conservative treatment of low back pain and sciatica; however, repeated exposure to radiation is a concern. With the blind technique, the needle misplacement rate is 30%; hence, ultrasound-guided caudal EDSI is a favored option. OBJECTIVE: To determine the efficacy of ultrasound-guided EDSI for low back pain and sciatica. METHODS: One hundred and ten patients with low back pain and sciatica who were unresponsive to conservative treatment, were prospectively recruited. Ultrasound-guided caudal EDSI was administered at 0, 3, and 6 weeks. Visual Analog Scale (VAS) score was recorded at 0, 2, 4, 12, and 24 weeks. Patients completed the Roland-Morris Disability Questionnaire (RMDQ) at pre-injection and 24 weeks post-injection. RESULTS: VAS was significantly reduced at 2, 4, 12, and 24 weeks (p< 0.01). At 2, 4, 12, and 24 weeks after injection, 20%, 26%, 74%, and 83% of patients displayed > 50% VAS reduction, respectively. The mean pre-injection RMDQ score was 15 and that post-injection at 24 weeks was 7 (p< 0.01). The majority of patients had > 50% reduction in the RMDQ score. CONCLUSIONS: Ultrasound-guided EDSI was safe and efficacious for low back pain and sciatica treatment at the intermediate follow-up.

Does Dynamic Taping Affect Pain, Endurance, Disability, Mobility, and Kinesiophobia in Individuals with Chronic Nonspecific Low Back Pain? A Randomized Controlled Trial

2021 ◽  
pp. 47
Author(s):  
Kanagaraj Rengaramanujam
Keyword(s):  
Randomized Controlled Trial ◽  
Low Back Pain ◽  
Back Pain ◽  
Outcome Measures ◽  
Controlled Trial ◽  
Control Group ◽  
Low Back ◽  
Short Term ◽  
Randomized Controlled ◽  
Pain Disability

Introduction: Evidence suggests that the application of Kinesio tape (KT) on patients with chronic nonspecific low back pain (CNLBP) is inconclusive. Dynamic tape (DT) is a relatively new treatment technique, which is increasingly being used as an adjunctive method to treat musculoskeletal problems. To the best of our knowledge, no study has investigated the application of DT in individuals with CNLBP. Thus, there is a need to compare the immediate and short-term effects of DT versus KT and no tape among patients with CNLBP on pain, endurance, disability, mobility, and kinesiophobia. Methodology: Forty-five patients with CNLBP were randomly divided into three groups: the DT group (n = 15), the KT group (n = 15), and the control group (n = 15). No tape was applied to the control group. The allocation and assessment procedures were blinded. The outcome measures were assessed before the tape application (baseline), 15 min after the tape application (immediate effect), and on the third day post tape application (short-term effect). The primary outcomes of pain, endurance, and disability were measured through the visual analog scale (VAS), Biering–Sorensen test, and Oswestry disability index (ODI), respectively. Secondary outcome measures of mobility and kinesiophobia were measured using the modified Schober test and the Tampa Scale of Kinesiophobia, respectively. Result: The demographic and baseline characteristics between groups were compared by the one-way analysis of variance (ANOVA) for parametric variables and the Chi-square test for nonparametric variables. A mixed-methods ANOVA (3 ´ 3) was used to analyze the main effect (group effect and time effect) and time ´ group interaction. No significant immediate and short-term differences were found between DT and KT in pain, disability, mobility, and kinesiophobia. Improved back extensor endurance was observed for the DT group compared to the KT (p = 0.023) and control (p = 0.006) groups. Conclusion: This randomized controlled trial showed that the DT does not have a significant additional effect on pain, disability, mobility, and kinesiophobia among individuals with CNLBP compared to KT. However, participants experienced significant improvement in back muscular endurance after the application of DT. This finding suggests that DT controls the processes that lead to back muscle fatigue. Therefore, more studies are required to examine the therapeutic benefits of DT in treating patients with CNLBP.

scholarly journals The Effectiveness of Thai Massage and Joint Mobilization

2017 ◽  
Vol 10 (2) ◽  
pp. 3
Author(s):  
Chantip Juntakarn, MA ◽  
Thavat Prasartritha, MD ◽  
Prapoj Petrakard, MD
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Outcome Measures ◽  
Randomized Study ◽  
Secondary Outcome ◽  
Control Group ◽  
Low Back ◽  
Short Term ◽  
Joint Mobilization ◽  
The Mean

Background: Non-specific low back pain (LBP) is a common health problem resulting from many risk factors and human behaviors. Some of thesemay interact synergistically and have been implicated in the cause of low back pain. Massage both traditional Thai massage and joint mobilization as a common practice has been shown to be effective for some subgroup of nonspecific LBP patients.Purpose and Setting: The trial compared the effectiveness between traditional Thai massage and joint mobilization for treating nonspecificLBP. Some associated factors were included. The study was conducted at the orthopedic outpatient department, Lerdsin General Hospital, Bangkok, Thailand.Methods: Prospective, randomized study was developed without control group. The required sample size was estimated based on previouscomparative studies for effectiveness between techniques. Two primary outcome measures were a 0 to 10 visual analog scale (VAS) of pain andOswestry Disability Index (ODI). Secondary outcome measures were satisfaction of patients and adverse effects of the treatment. The ‘‘intention to treat’’ (ITT) and per protocol approach were used to compare the significance of the difference between treatment groups.Participants: One hundred and twenty hospital outpatients, 20 (16.7%) male and 100 (83.3%) female, were randomized into traditional Thai massage and joint mobilization therapy. The average age of traditional Thai massage and joint mobilization was 50.7 years and 48.3 years, respectively. Both groups received each treatment for approximately 30 minutes twice per week over a four-week period. Total course did not exceed eight sessions.Result: With ITT, the mean VAS of traditional Thai massage group before treatment was 5.3 (SD = 1.7) and ODI was 24.9 (SD = 14.7), while in jointmobilization groups, the mean VAS was 5.0 (SD = 1.6) and ODI was 24.6 (SD = 15). After treatment, the mean VAS and ODI were significantlyreduced (VAS = 0.51 (SD = 0.89) and ODI = 8.1 (SD = 10.7) for traditional Thai massage, VAS = 0.86 (SD = 1.49) and ODI = 8.26 (SD = 12.97) for joint mobilization). Constipation was found in 34 patients (28.3%).Conclusion: The traditional Thai massage and joint mobilization used in this study were equally effective for short-term reduction of pain and disability in patients with chronic nonspecific LBP. Both techniques were safe with short term effect in a chosen group of patients.

Fluoroscopically guided caudal epidural steroid injections for axial low back pain associated with central disc protrusions: a prospective outcome study

2019 ◽  
Vol 43 (8) ◽  
pp. 1883-1889
Author(s):  
James J. Lee ◽  
Elizabeth T. Nguyen ◽  
Julian R. Harrison ◽  
Caitlin K. Gribbin ◽  
Nicole R. Hurwitz ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Outcome Study ◽  
Low Back ◽  
Steroid Injections ◽  
Epidural Steroid Injections ◽  
Central Disc ◽  
Epidural Steroid ◽  
Caudal Epidural

scholarly journals Efficacy of Ultrasono-Guided Caudal Epidural Steroid in Lumbar Disc Prolapse

KYAMC Journal ◽  
2020 ◽  
Vol 11 (2) ◽  
pp. 67-72
Author(s):  
Mohammad Moniruzzaman ◽  
Muhammad Alamgir Mandal ◽  
M Matiur Rahman ◽  
Syed Mozaffar Ahmed ◽  
Md Mustafizur Rahman ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Mean Difference ◽  
Lumbar Pain ◽  
Minimal Risk ◽  
Low Back ◽  
Female Ratio ◽  
Epidural Steroid ◽  
Caudal Epidural

Background: Ultrasono-guided caudal epidural steroid injections are used for the treatment of radicular lumbosacral pain syndromes with the safest, easiest, and minimal risk. Objective: The study is to show efficacy of ultrasono-guided caudal epidural steroid in acute and chronic low back pain due to prolapsed lumbar intervertebral disc (PLID). Materials and Methods: Thirty consecutive patients with acute and chronic low back pain with radiculopathy and without red flag sign where clinical diagnosis were prospectively included in this study in Popular Medical College Hospital, Dhanmondi, Dhaka. Results: The mean age was 40.83±13.34 (mean± SD). Male and female ratio was 3:2. Regarding diagnosis, 56.66% were acute and 43.33% were chronic low back pain in which 40% had lumbar canal stenosis, 70% had right sided radiation, 20% had left sided radiation and 10% had bilateral radiation. After 4 weeks, most of the study population was significantly improved regarding Visual Analogue Scale (VAS) score in lumbar pain and radiation pain, tenderness over lumbar spine, Straight Leg Raising (SLR) test and improvement of mean difference ± Standard Deviation (SD) after 4 weeks were 4.25±3.12, 4.58±1.58, 1.7±0.92 and 29.5±16.15 accordingly. Functional improvement of Oswestry Disability Index (ODI) from baseline 39.60±7.11 to 15.67±0.96. Mean difference of all variables were statistically significant. Conclusion: Ultrasound is an effective tool, not only to guide the insertion of the needle into the caudal epidural space, but also to predict the procedural success rate. KYAMC Journal Vol. 11, No.-2, July 2020, Page 67-72

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