Comparative study of three doses of epidural steroid injection with single dose of epidural steroid injection for lower back pain

Abstract

Introduction: Low Back pain and lumbar radicular pain due to is one of the most common complaint in OPD patients. Epidural steroid injection have well established role in the treatment of lumbar radicular pain, but the exact dose of Epidural Steroid injection has yet to be decided. The aim of this study is "To Compare three doses of epidural steroid injection with single dose of epidural steroid injection for Lumbar Radicular pain patients." Materials and Methods: 50 patients with lumbar radicular pain were randomly allocated into 2 groups. In group A 25 patients were given 120 mg of Depo-medrol (40 mg three times) and in group B 25 patients were given 40 mg of Depo-medrol as a single dose. Both group A and Group B were matched in terms of age and gender. On visual analogue score (VAS) pain was assessed after 2 weeks, 3 months and 6 months. Results: In group A (3 doses of depomedrol) VAS improvement at 2 weeks, 3 months and 6 months were more than group B(single dose of depomedrol) which was statistically significant (p < 0.05). There were no major complications like epidural hematoma or abscess formation in both groups. The overall minor complications like flushing, transient hyperglycemia and headache due to CSF hypotension were more in Group A than Group B but statistics shows no significant difference. All the complications resolved without any morbidity and no patient required further hospitalization. Conclusion:In the case of lumbar radicular pain, Epidural Steriod Injection with 3 doses of Depomedrol is more effective than a single dose of epidural steroid without significant increase risk of complications.