OBJECTIVE: To determine the difference in short- and long-term pain improvement between lumbar Epidural Steroid Injections (ESIs) and conservative management in patients with lumbar radiculopathy. STUDY DESIGN: Quasi-experimental study. PLACE AND DURATION OF STUDY: The Postgraduate Medical Institute of Hayatabad Medical Complex, Peshawar, from April 2005 to March 2007. METHODOLOGY:Fifty elective patients fulfilling the inclusion criteria were randomly divided into two groups. Patients in the steroid group were treated with 80 mg of methylprednisolone injected in combination with 3 ml of 2% plain xylocaine and 3 ml of normal saline in the lumbar epidural space, while patients in the conservative group were treated with bed rest, non-steroidal anti-inflammatory agents, muscle relaxants, and opioids. All the 50 patients in the two groups were regularly assessed at 2 weeks, 1 month, 3 months and 6 months of periods for pain score by the Visual Analogue Scale (VAS), patients satisfaction score and any unwanted side effects. RESULTS: A marked improvement of the pain score and patients satisfaction score were noticed in the steroid group. Less significant improvement was seen in the conservative group during the initial period i.e 2 weeks and 1 month (p < 0.05). The difference in Visual Analogue Scale (VAS) and patients satisfaction score was non-significant in chronic stages of treatment in both groups (p > 0.05). CONCLUSION:Epidural steroid injections in acute symptoms of sciatica are considered to be a better option compared to conservative treatment.
RCT Entities:
OBJECTIVE: To determine the difference in short- and long-term pain improvement between lumbar Epidural Steroid Injections (ESIs) and conservative management in patients with lumbar radiculopathy. STUDY DESIGN: Quasi-experimental study. PLACE AND DURATION OF STUDY: The Postgraduate Medical Institute of Hayatabad Medical Complex, Peshawar, from April 2005 to March 2007. METHODOLOGY: Fifty elective patients fulfilling the inclusion criteria were randomly divided into two groups. Patients in the steroid group were treated with 80 mg of methylprednisolone injected in combination with 3 ml of 2% plain xylocaine and 3 ml of normal saline in the lumbar epidural space, while patients in the conservative group were treated with bed rest, non-steroidal anti-inflammatory agents, muscle relaxants, and opioids. All the 50 patients in the two groups were regularly assessed at 2 weeks, 1 month, 3 months and 6 months of periods for pain score by the Visual Analogue Scale (VAS), patients satisfaction score and any unwanted side effects. RESULTS: A marked improvement of the pain score and patients satisfaction score were noticed in the steroid group. Less significant improvement was seen in the conservative group during the initial period i.e 2 weeks and 1 month (p < 0.05). The difference in Visual Analogue Scale (VAS) and patients satisfaction score was non-significant in chronic stages of treatment in both groups (p > 0.05). CONCLUSION: Epidural steroid injections in acute symptoms of sciatica are considered to be a better option compared to conservative treatment.
Authors: Laxmaiah Manchikanti; Ramsin M Benyamin; Frank J E Falco; Alan D Kaye; Joshua A Hirsch Journal: Clin Orthop Relat Res Date: 2015-06 Impact factor: 4.176
Authors: Thomas M de Bruijn; Ingrid B de Groot; Harald S Miedema; Johan Haumann; Raymond W J G Ostelo Journal: Clin J Pain Date: 2021-07-01 Impact factor: 3.442
Authors: Steven P Cohen; Steven Hanling; Mark C Bicket; Ronald L White; Elias Veizi; Connie Kurihara; Zirong Zhao; Salim Hayek; Kevin B Guthmiller; Scott R Griffith; Vitaly Gordin; Mirinda Anderson White; Yakov Vorobeychik; Paul F Pasquina Journal: BMJ Date: 2015-04-16