Epidural Steroid Injection and Nerve Root Block for Lumbar Radicular Pain

Background: Low back pain combined with radicular pain remains one of the most challenging musculoskeletal problems for its therapeutic management.Conservative treatment, percutaneous spine interventions and surgery have all been used as treatments; and the treatment that is chosen depends on the severity of the clinical and neurologic presentation.Many medical professionals currently use epidural steroid injections for the treatment of lumbosacral radiculopathy.Methods: A prospective study was conducted over one year at Dr. B.R. Ambedkar Medical College and Hospital, involving 70 patients of either gender with lumbar radiculopathy.Pre-procedure evaluation was done and patients were made fit for the procedure Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) score was assessed followed by assessment using the Oswestry Disability Index (ODI).Half of the sample patients were administered epidural steroid injections, remaining half were chosen for selective nerve root block procedure Follow-up of the patients was done at 1, 3 and 6 months, post-procedure and assessed using the Oswestry Disability Index (ODI) questionnaire.Results: Out of the 70 patients, 41 (58.5%) were male and 29 (41.5%) were female.The distribution of age of the patients was 30-70 years.Duration of symptoms at presentation ranges from 1 to 10 months with an average of 4.10 (3.13) months.L4L5 (72.8%) level was the most common level involved followed by L5S1 (18.5%), both L4L5/L5S1 together (7.1%) and L3L4 (1.4%).Conclusions: Epidural steroid injection is an easy and safe method with better pain relief and improvement of functional disability than nerve root block.The effect of nerve root block is short-acting in most of the patients and recurrence is repeated in some.It does not alter the prognosis of those specially with severe symptoms.