A Comparative Study of Outcomes of Treatments for Radiculopathies Arising out of Single Level Disc Prolapse of Lumbar Spine Treated with Epidural Steroid Injections Versus Conservative Management

Introduction:Low back pain is one of the major causes of disability in people in 4th and 5th decade of life. Lumbar spinal stenosis can induce radiating pain in the lower limbs. Pain can be caused due to mechanical compression or nerve root irritation due to prolapse which causes radiculitis. Hence, in early disc degenerations, apart from conservative management, Epidural steroid injections have been used as an add-on in treating radiating pain as they have a potent anti-inflammatory property. Materials and method: A total of one hundred patients with low back pain with unilateral or bilateral radiculopathy with documented with lumbar degenerative disc disease without any evident instability or neurodeficit were considered for our study.Patients were randomized and selected for further intervention for conservative management or for epidural steroid injections under fluoroscopic guidance.Results were evaluated by comparing the Visual analogue scale scores and Modified Roland Sciatica Scores at the end of six months.

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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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