Epidural corticosteroid injection and amitriptyline for the treatment of chronic low back pain associated with radiculopathy

Pirbudak, Lütfiye; Karakurum, Gunhan; Öner, Ünsal; Güleç, A. Tülin; Karadaşlı, Hakan

doi:10.1163/156856903767650763

Cited by 29 publications

(45 citation statements)

References 16 publications

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“…The duration of follow-up ranged from post treatment to 6 weeks. [149][150][151]158,173 The overall findings from five RCTs 152,153,158,171,173 showed epidural injections to be significantly better than inactive control for improving function. The findings were heterogeneous, with one poor-quality RCT 158 reporting a large effect size in favour of epidural injection.…”

Section: Condition-specific Outcome Measures At Short-term Follow-upmentioning

confidence: 99%

“…Epidural injections/nerve block were compared with inactive control, usual care, non-opioids, alternative therapy and mixed treatments. Three studies 150,167,175 included patients with chronic sciatica, one study 174 did not report the duration of symptoms, and the remaining studies included patients with either acute or chronic sciatica. The duration of follow-up ranged from post treatment to 6 weeks.…”

Section: Pain Intensity At Short-term Follow-upmentioning

confidence: 99%

“…One RCT 150 was of moderate quality, and included blinding of participants, clinicians and outcome assessors. Patients were randomly assigned to the two groups by one of the authors by drawing sealed envelopes from a box.…”

Section: Two Rctsmentioning

confidence: 99%

“…One moderate-quality RCT 150 found no statistically significant difference between epidural injection in combination with non-opioids (mixed treatments) and epidural injection alone for improving functional status for patients with chronic sciatica at 6 weeks' follow-up. 44 (15) 45 (18) 31 (15) 35 ( A + C, acute and chronic; C, chronic; LOCF, last observation carried forward.…”

Section: Condition-specific Outcome Measures At Short-term Follow-upmentioning

confidence: 99%

“…The duration of follow-up ranged from 60 days 159 to 6 months. 150,151,155,171,174 Four RCTs 152,162,171,173 compared epidural injections with inactive control, for which pooled analyses showed no important difference between the groups at 3 152,162,173 and 6 171 months. However, the findings were heterogeneous.…”

Section: Pain Intensity At Medium-term Follow-upmentioning

confidence: 99%

See 4 more Smart Citations

The clinical effectiveness and cost-effectiveness of management strategies for sciatica: systematic review and economic model

Lewis

Williams²,

Matar³

et al. 2011

Health Technol Assess

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How to obtain copies of this and other HTA programme reports An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address.Paying by credit card You can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume.How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTAThe clinical effectiveness and costeffectiveness of management strategies for sciatica: systematic review and economic model NIHR Health Technology Assessment programmeThe Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service' . The HTA pro...

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Section: Condition-specific Outcome Measures At Short-term Follow-upmentioning

confidence: 99%

Section: Pain Intensity At Short-term Follow-upmentioning

confidence: 99%

Section: Two Rctsmentioning

confidence: 99%

Section: Condition-specific Outcome Measures At Short-term Follow-upmentioning

confidence: 99%

Section: Pain Intensity At Medium-term Follow-upmentioning

confidence: 99%

See 3 more Smart Citations

The clinical effectiveness and cost-effectiveness of management strategies for sciatica: systematic review and economic model

Lewis

Williams²,

Matar³

et al. 2011

Health Technol Assess

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Antidepressants for non-specific low back pain

Urquhart

Hoving

Assendelft

et al. 2008

Cochrane Database of Systematic Reviews

134

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Combination pharmacotherapy for the treatment of neuropathic pain in adults

Chaparro

Wiffen

Moore³

et al. 2012

Cochrane Database of Systematic Reviews

242

212

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Background Pharmacotherapy remains an important modality for the treatment of neuropathic pain. However, as monotherapy current drugs are associated with limited e icacy and dose-related side e ects. Combining two or more di erent drugs may improve analgesic e icacy and, in some situations, reduce overall side e ects (e.g. if synergistic interactions allow for dose reductions of combined drugs). Objectives This review evaluated the e icacy, tolerability and safety of various drug combinations for the treatment of neuropathic pain. Search methods We identified randomised controlled trials (RCTs) of various drug combinations for neuropathic pain from CENTRAL, MEDLINE, EMBASE and handsearches of other reviews and trial registries. The most recent search was performed on 9 April 2012. Selection criteria Double-blind, randomised studies comparing combinations of two or more drugs (systemic or topical) to placebo and/or at least one other comparator for the treatment of neuropathic pain. Data collection and analysis Data extracted from each study included: proportion of participants a) reporting ≥ 30% pain reduction from baseline OR ≥ moderate pain relief OR ≥ moderate global improvement; b) dropping out of the trial due to treatment-emergent adverse e ects; c) reporting each specific adverse e ect (e.g. sedation, dizziness) of ≥ moderate severity. The primary comparison of interest was between study drug(s) and one or both single-agent comparators. We combined studies if they evaluated the same drug class combination at roughly similar doses and durations of treatment. We used RevMan 5 to analyse data for binary outcomes. Main results We identified 21 eligible studies: four (578 participants) evaluated the combination of an opioid with gabapentin or pregabalin; two (77 participants) evaluated an opioid with a tricyclic antidepressant; one (56 participants) of gabapentin and nortriptyline; one (120 participants) of gabapentin and alpha-lipoic acid, three (90 participants) of fluphenazine with a tricyclic antidepressant; three (90 participants) of an N-methyl-D-aspartate (NMDA) blocker with an agent from a di erent drug class; five (604 participants) of various topical medications; one (313 participants) of tramadol with acetaminophen; and another one (44 participants) of a cholecystokinin blocker (L-365,260) with morphine. The majority of combinations evaluated to date involve drugs, each of which share some element of central nervous system (CNS) depression (e.g. sedation, cognitive dysfunction). This aspect of side e ect overlap between the combined Combination pharmacotherapy for the treatment of neuropathic pain in adults (Review)

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Epidural corticosteroid injection and amitriptyline for the treatment of chronic low back pain associated with radiculopathy

Cited by 29 publications

References 16 publications

The clinical effectiveness and cost-effectiveness of management strategies for sciatica: systematic review and economic model

The clinical effectiveness and cost-effectiveness of management strategies for sciatica: systematic review and economic model

Antidepressants for non-specific low back pain

Combination pharmacotherapy for the treatment of neuropathic pain in adults

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