scholarly journals Comparison of Epidural Steroid Injections with Conservative Management in Patients with Lumbar Radiculopathy

2014 ◽  
Vol 26 (1) ◽  
pp. 09-11
Author(s):  
Md Mahmudur Rahman ◽  
Md Imamur Rashid ◽  
Nadia Rahman ◽  
MA Shakoor
Keyword(s):  
Back Pain ◽  
Treatment Group ◽  
Conservative Treatment ◽  
Steroid Injection ◽  
Epidural Steroid Injection ◽  
Leg Pain ◽  
Therapeutic Exercises ◽  
Group A ◽  
Group B ◽  
Epidural Steroid

Pain in the back is the most common of all chronic pain disorders. Back pain and sciatica, or leg pain originating from injury to or pressure on the sciatic nerve, are major causes of disability in adults, occurring in 15% to 20% of the working-age population annually and 70% to 90% of adults at some point in their lives. Men and women are affected equally. The study was conducted prospectively in 60 patients of 18 to 60 years of age with documented chronic low back pain with sciatica. Thirty patients were treated in group-A with conservative treatment (NSAID+ therapeutic exercises+ superficial thermotherapy and ADL instruction) plus epidural steroid injection and 30 samples were treated in group B with conservative treatment only. Epidural steroid injection treatment group is significantly improved than conservative treatment group (p<0.05). There was more improvement of pain in group –A than in Group B ( p= 0.007) and SLR was more increased in group –A than group-B (p=0.03). So, epidural steroid injection is a effective treatment for lumber rediculopathy especially in acute phase. DOI: http://dx.doi.org/10.3329/medtoday.v26i1.21302 Medicine Today 2014 Vol.26(1): 09-11

scholarly journals EPIDURAL STEROID INJECTION IN HERNIATED DISC AND LUMBAR CANAL STENOSIS: IS IT JUST A PLACEBO?

2021 ◽  
Vol 20 (3) ◽  
pp. 189-191
Author(s):  
AJAY KUMAR SHETTY PAPANNA ◽  
SUJITH RAO VITTALDAS ◽  
BALAMURUGAN THIRUGNANAM ◽  
VIDYADHARA SRINIVASA
Keyword(s):  
Back Pain ◽  
Pain Score ◽  
Steroid Injection ◽  
Epidural Steroid Injection ◽  
Leg Pain ◽  
P Value ◽  
Lumbar Canal Stenosis ◽  
Canal Stenosis ◽  
The Mean ◽  
Epidural Steroid

ABSTRACT Objective To study the role of epidural steroid injection (ESI) in patients with lumbar disc herniation (LDH) and lumbar canal stenosis (LCS). ESIs are regularly used to support non-operative treatment for LBP, and our anecdotal impression is that a considerable proportion of patients report substantial pain relief after ESI. Methods One thousand consecutive patients (645 patients with LDH and 355 patients with LCS) who required ESI from January-August 2018 were included. All were given the same ESI, prepared with triamcinolone (80 mg), bupivacaine (0.25%, 4 ml) and normal saline (4 ml). Patients were evaluated using the numerical rating scale (NRS) immediately after the injection, after 7 days, and after 3 months. Results The mean NRS back-pain score of the LDH-group was reduced from 5 (range: 4-8) to 4 (range: 2-7) immediately after injection, 2 (range: 1-7) after 7 days and 2 (range: 1-7) after 3 months (p-value<0.001). The mean NRS back-pain score of the LCS-group was reduced from 5 (range: 4-8) to 4 (range: 2-7) immediately after injection, 2 (range: 1-7) after 7 days and 3 (range: 1-7) after 3 months (p-value <0.001). The mean NRS leg-pain score of the LDH group was reduced from 5 (range: 4-9) to 3 (range: 3-7) immediately after injection, 1 (range: 1-6) after 7 days and 2 (range: 1-7) after 3 months (p-value <0.001). The mean NRS leg-pain score of the LCS group was reduced from 5 (range: 4-9) to 4 (range: 3-7) immediately after injection, 3 (range: 1-7) after 7 days and 2 (range 1-6) after 3 months (p-value <0.001). Conclusion ESI causes statistically significant improvement in back and leg pain in patients with LDH and LCS. However, the short and medium-term efficacy of ESI in the LCS group was lower than in the LDH group. Level of evidence IV; Prospective hospital-based study.

scholarly journals SPINAL STENOSIS

2018 ◽  
Vol 25 (09) ◽  
pp. 1323-1327
Author(s):  
Saeed Ahmad ◽  
Haseeb Hussain ◽  
Ashfaq Ahmed ◽  
Rizwan Akram ◽  
Ijaz Ahmed ◽  
...  
Keyword(s):  
Single Dose ◽  
Spinal Stenosis ◽  
Local Anesthesia ◽  
Steroid Injection ◽  
Epidural Steroid Injection ◽  
Lower Back ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Epidural Steroid

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.

scholarly journals Study of role of caudal epidural steroid in management of low back pain in Malayalam patients

2019 ◽  
Vol 5 (6) ◽  
pp. 1098
Author(s):  
Jayakrishnan Rajasekharan
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Steroid Injection ◽  
Epidural Steroid Injection ◽  
Leg Pain ◽  
Lumbar Region ◽  
Low Back ◽  
Visual Analogue Scale Scale ◽  
Epidural Steroid ◽  
Caudal Epidural

<p class="abstract"><strong>Background:</strong> 85 patients of different age groups were treated with caudal epidural steroid injection for the management of low back pain. As low back pain is quite common in adults.</p><p class="abstract"><strong>Methods:</strong> X-ray, MRI of the lumbar region was studied. Degree of the pain was assessed by VAS (visual analogue scale) scale, study of Lumbo-sacral joint was studied to know the causes of low back pain (LBP).<strong></strong></p><p class="abstract"><strong>Results:</strong> As per the MRI study classification LBP was classified as, 16 (16.3%) had Acute back pain without any cause, 14 (14.2%) had spondylolithesis having symptoms of claudication with low back pain. 26 (26.5%) had stenosis of Lumbar canal with symptoms of claudication 42 (42.8%) had disc degeneration with or without root radiation having complaint of back pain and leg pain. The improvement as per VAS scale was from 1 week to 3 months in the management of LBP.</p><p align="center"><strong>Conclusions:</strong> This pragmatic approach to various causes of low back pain managed with epidural steroid injection will be useful to orthopedic surgeon to treat such pain efficiently because back pain becomes common factor as age advances due to resorption or degenerative factors andcurvatures of vertebral column becomes less pronounceds. </p>

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.

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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