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Assessment of the implication of epidural steroid injection versus other conservative measures in the management of lumbar disc herniation

Abstract

Introduction

The aim of this work was to compare the potential efficacy of epidural steroid injection versus other conservative measures for relieving pain and improving function in patients with lumbar disc herniation (LDH).

Methods

This study included 45 patients who presented with low back pain and sciatica due to LDH (at levels of L4–L5 or L5–S1) diagnosed clinically and confirmed by means of MRI. Patients were classified into two groups: group I (15 patients) was treated with drugs and physiotherapy, and group II (30 patients) was subclassified into two subgroups of 15 patients each (group IIL received lumbar epidural injection, whereas group IIC received caudal epidural injection). All patients were assessed at presentation and after starting the treatment at the first week and first, second, and third month using the visual analogue scale (VAS) for pain and the Oswestry Disability Index (ODI) for function status.

Results

Groups I, IIL, and IIC showed improvement in pain and function, confirmed by a decrease in the mean VAS and ODI scores. Both groups of injection showed a significant difference (P < 0.05) when compared with group I with regard to VAS and ODI. There was an insignificant difference (P > 0.05) between the lumbar and caudal groups in the VAS, except at the second month (P < 0.05), and in the ODI, except at first week and first month (P < 0.05).

Conclusion

Epidural injection could be a preferable choice in managing low back and radicular pain due to LDH. It was a clinically useful mode of treatment that is cost-effective and could offset the need for surgery.

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Correspondence to Amal F. Soliman MD.

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Soliman, A.F., Hammad, G.A., El-gamal, R.I. et al. Assessment of the implication of epidural steroid injection versus other conservative measures in the management of lumbar disc herniation. Egypt Rheumatol Rehabil 43, 53–58 (2016). https://doi.org/10.4103/1110-161X.181867

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Keywords

  • conservative treatment
  • epidural steroid injection
  • lumber disc herniation