A prospective study on the role of epidural steroidal injections in backache with radiculopathy

Akhil Gupta, Nitin Choudhary, Fareed Hussain Malik

Abstract

Background: Low backache (LBA) with lumbosacral radiculopathy is the most challenging musculoskeletal problem for its therapeutic management and cause of LBA with radiculopathy is a prolapsed disc. Epidural steroidal injection (ESI) are used in the management of the patients with sub-acute or chronic LBA with radiculopathy, not responding to conservative treatment. The most common cause being, lumbar disc disease, is confirmed via magnetic resonance imaging having high sensitivity and specificity.  The aim of study was to check the efficacy of ESI in patients of sub-acute or chronic low backache with radiculopathy due to herniated disc.

Methods: The study was conducted over 200 patients reporting our OPD during Dec 2017- Feb 2018 with complaints of LBA with radiculopathy, not responding to conservative treatment. Maximum of 3 ESI were given with two weeks of interval in between. The patients were assessed using VAS scoring system.

Results: 77.5% patients got improvement in symptoms, according to the VAS scores, while 22.5% patients got very little relief or no relief at all. 53.5% patients got significant improvement with the first dose of injection itself. Patients had a good relief from radicular pain immediately; however, sense of satisfaction of well-being was only after few months.

Conclusions: Though results supported the relative benefit of epidural steroid, however conservative management should also be recommended as initial treatment. ESI procedure is effective in treating patients of sub-acute LBA with radiculopathy and is recommended before a patient is considered for surgery.

Keywords

Epidural steroid, Low back ache, Visual analogue scale, Efficacy

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