Comparative study of three doses of epidural steroid injection with single dose of epidural steroid injection for lower back pain

Introduction: Spinal stenosis causing lower back pain and radiculopathy andit is the most common cause of patient admission at Spine centre as compared to other spinepathologies. Most common complaint in the Spine outpatient department or hospital admissionsDifferent modalities have been applied with time for its management. Among them Epiduralsteroid injection is also. Objectives: “To Compare three doses of epidural steroid injection withsingle dose of epidural steroid injection for Lumbar Radicular pain in spinal stenosis patients.”Study Design: Prospective study. Setting: Ghurki Trust Teaching Hospital, Lahore, Pakistan.Period: Jan 2016 to Dec 2016. Materials and Methods: 95 patients with lumbar radicular paindue to spinal stenosis were randomly allocated into 2 groups. In Group A, 42 patients were given120 mg of Depo-medrol (40 mg per day for 3 days) along with local anesthesia and in group B,43 patients were given 40 mg of Depo-medrol with local anesthesia as a single dose. Both GroupA and Group B were matched in terms of age and gender. On visual analogue scoring, pain wasassessed after 2 weeks, 3 months and 6 months. Results: In Group A (3 doses of depomedrol)VAS improvement at 2 weeks, 3 months and 6 months were more than group B (single dose ofdepomedrol) which was statistically significant (p < 0.05). There were no major complicationslike epidural hematoma or abscess formation in both groups. The overall minor complicationslike flushing, transient hyperglycemia and headache due to CSF hypotension were more inGroup A than Group B but statistics shows no significant difference. All the adverse eventsresolved within few days without any significant morbidity and subsequent hospitalizations.Conclusion: Epidural steroid injection is excellent modality in the treatment of lower back painwith radiculopathy. Moreover 3 doses have greater effect in relieving pain as compared to singledose. There is no increase risk of complications by increasing dose.

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

Pain Management ◽

10.2217/pmt-2021-0093 ◽

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.

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Faculty of 1000 evaluation for Lateral parasagittal versus midline interlaminar lumbar epidural steroid injection for management of low back pain with lumbosacral radicular pain: a double-blind, randomized study.

F1000 - Post-publication peer review of the biomedical literature ◽

10.3410/f.718016059.793478414 ◽

2013 ◽

Author(s):

Jan Jakobsson

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Steroid Injection ◽

Randomized Study ◽

Radicular Pain ◽

Epidural Steroid Injection ◽

Low Back ◽

Double Blind ◽

Epidural Steroid

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Role of psychological distress screening in predicting the outcomes of epidural steroid injection in chronic low back pain

Journal of Clinical Orthopaedics and Trauma ◽

10.1016/j.jcot.2021.04.027 ◽

2021 ◽

Author(s):

Rohit Jindal ◽

Greg Rudol ◽

Benjamin Okafor ◽

Rohit Rambani

Keyword(s):

Low Back Pain ◽

Psychological Distress ◽

Back Pain ◽

Chronic Low Back Pain ◽

Steroid Injection ◽

Epidural Steroid Injection ◽

Low Back ◽

Distress Screening ◽

Epidural Steroid

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

10.36106/2536610 ◽

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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