Relief of low back pain by epidural injection. A case report

This report describes the use of epidural injection in the treatment of a patient with severe back pain whose medical history and physical examination suggest a diagnosis of a lumbar disk lesion. The patient's medical history included recurrent episodes of buttock and hip pain that previously responded well to lumbar manipulation. On this occasion, the pain had become so severe that the patient could not tolerate manipulation. The patient's pain was relieved by administering an epidural injection of 50 cc of 0.5% procaine through the sacral hiatus. This injection has two relevant implications for the physical therapy profession. First, it offers a nonsurgical treatment for a lumbar disk lesion when physical therapy has been ineffective or is impractical. Second, in an appropriate clinical setting, the epidural injection provides an opportunity to understand more clearly the causes of back pain.