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Epidural application of cortico-steroids in low-back pain and sciatica
1University Clinic of Neurosurgery, Rigshospitalet, Copenhagen, Denmark.
Acta Neurochirurgica
|January 1, 1987
Summary
Epidural steroid injections provided minimal short-term pain relief for patients with chronic lumbar pain and sciatica, especially those with prior surgery. The study found these injections largely ineffective for this patient group.
Area of Science:
- Pain Management
- Neurosurgery
- Pharmacology
Background:
- Chronic lumbar pain and sciatica significantly impact quality of life.
- Epidural steroid injections are a common treatment for radicular pain.
- Previous studies have shown variable efficacy of epidural steroid injections.
Purpose of the Study:
- To evaluate the effectiveness of epidural steroid injections in patients with chronic lumbar pain and sciatica.
- To assess the efficacy in patients with a history of lumbar surgery.
Main Methods:
- 16 patients with lumbar pain and sciatica received a single epidural block with depo-medrol and lidocaine.
- Patients had long-standing pain, negative radiculography, and some had prior hemilaminectomy.
- Pain relief was assessed using a visual analog scale at various time points.
Main Results:
- 62% of patients reported at least 50% pain relief the day after injection.
- One month later, only 43% reported one-third pain relief.
- Ultimately, only one patient experienced sustained benefit; others remained unaffected.
Conclusions:
- Epidural steroid injections showed limited and transient pain relief in this cohort.
- The treatment was found to be largely ineffective for patients with long-lasting complaints and previous lumbar operations.
- These findings contrast with other reports and led to the abandonment of a planned randomized trial.