scholarly journals Comparison of the effectiveness between epidural methylprednisolone injection and intranasal calcitonin in reduction of back pain due to osteoporosis in postmenopausal patients: a randomized controlled trial

2020 ◽  
Vol 7 (3) ◽  
pp. 188
Author(s):  
Kanti Rajkumari ◽  
Akoijam Joy Singh ◽  
Longjam Nilachandra Singh
Keyword(s):  
Back Pain ◽  
Pain Relief ◽  
Steroid Injection ◽  
Outcome Measurement ◽  
Controlled Trial ◽  
Compression Fracture ◽  
Epidural Steroid Injection ◽  
Common Symptom ◽  
Epidural Group ◽  
Epidural Steroid

<p class="abstract"><strong>Background:</strong> Back pain is a common symptom in osteoporotic patients due to spinal compression fracture. Conservative management like nonsteroidal anti-inflammatory drugs and spinal orthoses has not been able to produce early pain relief. Intranasal calcitonin spray is considered effective because of its analgesic effect and increase in bone density. Role of epidural steroid injection for the treatment of osteoporotic back pain has not been studied. This study was conducted to find out the efficacy of epidural methylprednisolone injection in management of osteoporotic back pain in postmenopausal patients.</p><p class="abstract"><strong>Methods:</strong> Hundred patients with osteoporotic back pain in postmenopausal subjects were allocated into two groups: epidural and calcitonin. Epidural group received a single dose of interlaminar epidural steroid injection with methylprednisolone 80 mg. Calcitonin group received one puff of 200 IU given through one nostril followed to the other nostril the next day. Visual analogue scale for pain was the outcome measurement used. Pain relief at rest within 7 days was taken as early pain relief and within 21days as late pain relief. Pain relief after 21<sup>st</sup> day was considered no response. Test of significance was done by Kaplan Meier, Chi square and Fisher exact tests.</p><p class="abstract"><strong>Results:</strong> Out of 50 patients, 38 patients in the epidural group got pain relief within 7 days and the finding was statistically significant.</p><p class="abstract"><strong>Conclusions: </strong>Epidural methylprednisolone gives faster pain relief as early as the first post-injection day with a median value of 2 days against 15 days in case of intranasal calcitonin spray.</p>

The period of pain relief following a successful epidural steroid injection for low-back pain

2002 ◽  
Vol 13 (4) ◽  
pp. 331-338 ◽  
Author(s):  
Henk M. Koning ◽  
Alex J. Koning ◽  
Tobias C. M. Bruinen ◽  
Hans G. Koster ◽  
Evert Heybroek
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Relief ◽  
Steroid Injection ◽  
Epidural Steroid Injection ◽  
Low Back ◽  
Epidural Steroid

scholarly journals Concordant Pressure Paresthesia During Interlaminar Lumbar Epidural Steroid Injections Correlates with Pain Relief in Patients with Unilateral Radicular Pain

2013 ◽  
Vol 5;16 (5;9) ◽  
pp. 497-511
Author(s):  
Kenneth D. Candido
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Relief ◽  
Steroid Injection ◽  
Radicular Pain ◽  
Epidural Steroid Injection ◽  
Low Back ◽  
Epidural Steroid Injections ◽  
Interlaminar Approach ◽  
Epidural Steroid

Background: Transforaminal and interlaminar epidural steroid injections are commonly used interventional pain management procedures in the treatment of radicular low back pain. Even though several studies have shown that transforaminal injections provide enhanced short-term outcomes in patients with radicular and low back pain, they have also been associated with a higher incidence of unintentional intravascular injection and often dire consequences than have interlaminar injections. Objectives: We compared 2 different approaches, midline and lateral parasagittal, of lumbar interlaminar epidural steroid injection (LESI) in patients with unilateral lumbosacral radiculopathic pain. We also tested the role of concordant pressure paresthesia occurring during LESI as a prognostic factor in determining the efficacy of LESI. Study Design: Prospective, randomized, blinded study. Setting: Pain management center, part of a teaching-community hospital in a major metropolitan US city. Methods: After Institutional Review Board approval, 106 patients undergoing LESI for radicular low back pain were randomly assigned to one of 2 groups (53 patients each) based on approach: midline interlaminar (MIL) and lateral parasagittal interlaminar (PIL). Patients were asked to grade any pressure paresthesia as occurring ipsilaterally or contralaterally to their “usual and customary pain,” or in a distribution atypical of their daily pain. Other variables such as: the Oswestry Disability Index questionnaire, pain scores at rest and during movement, use of pain medications, etc. were recorded 20 minutes before the procedure, and on days 1, 7, 14, 21, 28, 60, 120, 180 and 365 after the injection. Results: Results of this study showed statistically and clinically significant pain relief in patients undergoing LESI by both the MIL and PIL approaches. Patients receiving LESI using the lateral parasagittal approach had statistically and clinically longer pain relief then patients receiving LESI via a midline approach. They also had slightly better quality of life scores and improvement in everyday functionality; they also used less pain medications than patients receiving LESI using a midline approach. Furthermore, patients in the PIL group described significantly higher rates of concordant moderate-to-severe pressure paresthesia in the distributions of their “usual and customary pain” compared to the MIL group. In addition, patients who had concordant pressure paresthesia and no discordant pressure paresthesia (i.e., “opposite side or atypical”) during interventional treatment had better and longer pain relief after LESI. Two patients from each group required discectomy surgery in the one-year observation period. Limitations: The major limitation of this study is that we did not include a transforaminal epidural steroid injection group, since that is one of the approaches still commonly used in contemporary pain practices for the treatment of low back pain with unilateral radicular pain. Conclusions: This study showed that the lateral parasagittal interlaminar approach was more effective than the midline interlaminar approach in targeting low back pain with unilateral radicular pain secondary to degenerative lumbar disc disease. It also showed that pressure paresthesia occurring ipsilaterally during an LESI correlates with pain relief and may therefore be used as a prognostic factor. Key words: lumbar epidural steroid injection, interlaminar injection, low back pain, unilateral radicular pain, midline interlaminar approach, lateral parasagittal interlaminar approach, pressure paresthesia, quality of life, everyday functionality

scholarly journals Effect of supraneural transforaminal epidural steroid injection combined with caudal epidural steroid injection with catheter in chronic radicular pain management: Double blinded randomized controlled trial.

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 634
Author(s):  
Sithapan Munjupong ◽  
Wipoo Kumnerddee
Keyword(s):  
Randomized Controlled Trial ◽  
Pain Relief ◽  
Functional Outcomes ◽  
Steroid Injection ◽  
Controlled Trial ◽  
Radicular Pain ◽  
Epidural Steroid Injection ◽  
Randomized Controlled ◽  
Significant Pain ◽  
Epidural Steroid

Background: Epidural steroid injection (ESI) has been used in managing chronic radicular pain. Regarding various techniques of ESI, the synergistic effect of caudal ESI (CESI) on transforaminal ESI (TFESI) in chronic lumbosacral radicular pain in prospective randomized controlled trial has not been determined. Methods:  A total of 54 eligible patients with lumbosacral radicular pain were randomly allocated to undergo TFESI plus CESI (TC group) or TFESI alone (T group).  The effective response to treatment was predefined by at least a 30% reduced verbal numerical rating scale (VNRS) from baseline between group comparison and the functional outcomes as measured by improved Oswestry Disability Index by least 15 points from baseline. All participants were evaluated using a single blinded outcome assessor before the  procedure and at 1, 3 and 6 months after the procedure. P <0.05 was considered as statistically significant. Results:  Average VNRS reduced significantly from baseline after receiving procedure at 1, 3 and 6 months in both groups (P-value <0.05). The TC group exhibited more effective and showed significant pain relief compared with the T group at 3 months (P=0.01). However, no statistical difference was observed between sub group analysis in pain relief and insignificant difference between group comparisons of functional outcomes. Conclusions: A treatment combining TFESI and CESI showed significant pain relief over TFESI alone at 3 months. No effect was found concerning functional evaluation. Registration: Thai Clinical Trials Registry ID TCTR20171101002 01/11/2017F

EFFECTIVENESS OF EPIDURAL STEROID INJECTION FOR THE MANAGEMENT OF CHRONIC LOW BACK PAIN.

2021 ◽  
pp. 52-54
Author(s):  
Ravi Ranjan Singh ◽  
Bharat Singh
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Steroid Injection ◽  
Lumbar Disc ◽  
Radicular Pain ◽  
Epidural Steroid Injection ◽  
Low Back ◽  
Herniated Lumbar Disc ◽  
Epidural Steroid

INTRODUCTION: Low-back pain is a common clinical presentation of herniated lumbar disc. The incidence of low back pain is high in our country due to difcult working and living environment. The initial treatment of low back pain is conservative. Epidural steroid injection (ESI) is being slowly established as a simple, effective and minimally invasive treatment modality. The aim of this study is to assess the effectiveness of epidural steroid injection for low back and radicular pain. MATERIALS AND METHODS :This is a Prospective observational study. It was carried out on the patients presenting with low back pain due to herniated lumbar disc not responding to conservational management and had Magnetic Resonance Imaging (MRI) proven lumbar disc prolapsed at different level. Injection Methyl prednisolone 80 mg and 2 ml of 0.5% bupivacaine was diluted in 8 ml of normal saline and injected into the affected lumbar epidural space. The functional status of the patient and the severity of pain were evaluated before injection and after injection during the follow-up period by using Ostrewy disability index and visual analogue score. RESULTS: Fifty six patients received the epidural steroid injections, among them three patients did not came for regular follow up till six months and six patients required surgery . remaining forty seven were analyzed , among them 27(55.44%) were male and 20(42.55%) were female. The functional status and pain response of the patients were improved signicantly during all the follow-up periods (p < 0.001). The success rate of this study was 83.92%. No major complications were encountered. CONCLUSION:The ESI is a simple, safe, effective and minimally invasive modality for the management of lumbar radicular pain.

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