Our experience with epidural steroid injections in the management of low back pain and sciatica

Abstract

Background: Low back pain (LBP) and sciatica is a common clinical condition worldwide.The initial treatment of Low back pain is conservative. Epidural steroid injection (ESI) is being slowly established as a reliable mode of conservative management in many orthopaedic centres of the world. This is a preliminary report of on-going study of the use of epidural steroid injection the management of low back pain cases coming to the orthopaedic department of Government Medical College Jammu. Methods: 150 Patients reporting with low back pain and sciatica not responding to other modes of conservative treatment were prospectively followed over a two year period. The caudal epidural steroid injections were performed, as many as three injections two week apart .The patients were assessed before and after the procedure clinically and the Level of pain, improvement in physical signs and ability to do activities of daily living were noted. Results:150 patients were observed for the duration of 2 years. Average duration of symptoms was for six months. After first epidural steroid injection 80% [120] of patients reported relief within first two weeks. Forty Four (44) patients required two injections and 12 patients required three injections. Twelve (12) patients reported no relief after first injection. The duration between two injections was two to three weeks. Average duration of pain relief was 17days. At the end of three months, good results were seen in 49%, fair in 32% and bad results in 18%. Overall 69% of patients were able to do activities of daily living. Most common complaint of patients after injection was pain at the injection site. No major complications were encountered. Conclusion: Epidural Steroid Injection is a simple, cost effective and minimally invasivemode of treatment of Low Back Pain and sciatica. It provides pain free period to enable the patient for physiotherapy which helps in early recovery.