Efficacy of caudal epidural steroid injections in the management of chronic lower back pain: prospective observational study
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 8, Pages 5357-5362
AbstractBackground: Low back ache is the most common problem seen in orthopaedic clinic. Low backache with lumbosacral radiculopathy remains the most challenging musculoskeletal problem for its therapeutic management. In around 90% patients, the cause of low back with radiculopathy is a prolapsed disc. Epidural steroid injections are used in the management of patients with sub acute or chronic low backache with radiculopathy, not responding to conservative treatment.
Aim: The aim of this study was to find Role of caudal epidural steroid injections in the management of chronic low backache.
Materials and Methods: A prospective study was conducted in the Department of Orthopaedics, Department of Orthopaedics, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India for 2 years. Total 80 Patients with chronic low back pain and sensory symptoms not responding to conservative management were include in this study. They were evaluated clinically before and after epidural steroid on the basis of pain, unrestricted activities of day to day life and work performance on the basis of visual analogue scale and Oswestry disability index.
Results: Total 165 ESI were given to 120 patients. 85 patients were given single injection, while 25 had two and 10 received three ESI doses. Out of 120, 50 were males and 70 females with chronic LBP. Out of 120 cases of LBP, Lumbar disc herniation was seen in 37, lumbar canal stenosis in 11 and degenerative disc disease in 22 cases while 50 cases had non-specific LBP. Follow up was done at one week, one month and then every three months up to twelve months of treatment (post third ESI 9 months). Mean pre ESI, VAS was 7.11while it was 4.82 at one year of treatment. Mean pre ESI, ODI score was 59.12 while after twelve months of treatment with ESI it was 44.64 at one year. We obtained excellent results in 27.5 percent, good in 38.33 percent, fair in 21.67 percent while poor in 12.5 percent patients.
Conclusion ESIs are very effective and significantly reduce pain in patients with chronic function-limiting LBP. Keywords: Low back pain, Epidural steroid injections.
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