Aerobic versus Core‑stabilization Training after Caudal Epidural Steroid İnjection for Lumbar Disc Herniation

OBJECTIVE: To compare the effects of adding supervised aerobic or core stabilization exercise to physiotherapy on pain and function after caudal epidural steroid injection (CESI) in individuals with lumbar disc herniation (LDH) and radicular pain. DESIGN: Three-arm parallel-group randomized controlled trial with 12-week follow-up. Thirty-five individuals were divided into three groups. For six weeks, the control group received physiotherapy. Aerobic and stabilization groups received the same programme plus 20 min of exercise. Primary outcome was pain (Visual Analogue Scale, VAS). Secondary outcomes included disability (Oswestry Disability Index, ODI), quality of life (SF-12), and back awareness (FreBAQ). RESULTS: Both exercise groups showed significantly greater improvement in VAS and secondary outcomes at 6 weeks compared to control(P<0.05). The stabilization group achieved faster pain reduction by week 6 than the aerobic group. By 12 weeks, aerobic and stabilization outcomes were comparable and remained superior to control. CONCLUSIONS: In patients with LDH, adding aerobic or core stabilization to CESI produced greater pain relief and functional improvement than CESI with physiotherapy alone. Core stabilization yielded quicker initial pain relief, though both approaches were similarly effective by week 12. These findings underscore the clinical value of exercise programmes following CESI. CLINICAL TRIAL NUMBER: NCT06956664.