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Effect of Transforaminal Epidural Corticosteroid Injections in Acute Sciatica: A Randomized Controlled Trial
Bastiaan C Ter Meulen1,2,3, Johanna M van Dongen2,3, Esther Maas3
1Department of Neurology at OLVG Teaching Hospital.
The Clinical Journal of Pain
|September 15, 2023
Summary
Transforaminal epidural steroid injections (TESIs) showed a significant effect on leg pain for acute sciatica patients compared to usual care. However, TESIs were associated with reduced opioid use, warranting further investigation.
Area of Science:
- Pain Management
- Neurology
- Orthopedics
Background:
- Sciatica is a common condition often treated with transforaminal epidural steroid injections (TESIs).
- The effectiveness of TESIs in acute sciatica (<8 weeks) requires further evaluation.
Purpose of the Study:
- To assess the efficacy of TESIs in patients experiencing acute sciatica.
- To compare TESI with usual care, including medication and physiotherapy.
Main Methods:
- A randomized trial in two Dutch hospitals involving 141 participants.
- Intervention groups received TESI with corticosteroids or local anesthetics; control group received usual care.
- Co-primary outcomes included back and leg pain, physical functioning, and recovery over 6 months.
Main Results:
- No significant differences in co-primary outcomes between groups, except for leg pain in intervention group 1 versus control.
- Intervention group 1 showed a statistically significant improvement in leg pain at 3 months.
- Both intervention groups demonstrated reduced opioid use compared to the control group.
Conclusions:
- TESIs offer a statistically significant benefit for leg pain in acute sciatica patients compared to usual care.
- Transforaminal epidural injections may lead to decreased opioid consumption, meriting additional research.
