Versus other conservative measures in the management of lumbar disc herniation

• Published in: Egyptian Rheumatology and Rehabilitation Vol. 43; no. 2; pp. 53 - 58
• Main Authors: Sulayman, Amal F., al-Jamal, Ranina I., Hammad, Jamal A., al-Rabi, Muhammad A.
• Format: Journal Article
• Language: English
• Published: Cairo, Egypt The Egyptian Society for Rheumatology and Rehabilitation 2016
• Subjects: Hernia; Intervertebral disk; Pain; Steroids; Treatment; الألم; الستيرويد; الليبيدات
• ISSN: 1110-161X; 2090-3235

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 І (15 patients) was treated with drugs and physiotherapy,
and group ІІ (30 patients) was subclassified into two subgroups of 15 patients each (group ІІL
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 І, ІІL, 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 І 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.