Evaluation of epidural injection of steroid methyl prednisolone, linocaine and normal saline through the lumber epidural route in the management of low back pain

Abstract

Background: Epidural injections have been used for decades for treatment of low back pain. The use of extradural medication to relieve back-ache has been studied in recent years and encouraging results have been published. The present study deals with the epidural injection of steroid methyl prednisolone, lignocaine and normal saline combination in the management of low back pain. Method: The present prospective study was conducted on 50 patients with low back pain form Karnataka Institute of Medical Sciences Hospital, Hubli were selected. All the patients were admitted and referred from the orthopedic department of the Karnataka Institute of Medical Sciences, Hubli to the Pain Clinic of our Anesthesiology Department, after they failed to improve with two weeks of conservative therapy such as bed rest, skin traction and non-steroidal anti-inflammatory drugs. Out of 50 patients 36 were males and 14 were females (n=50). Study was explained to the patients and the informed consent was obtained from all the patients. Result: The pain relief was assessed by VAS and the score was excellent in 23.91%, good in 47.82%, satisfactory in 15.22 and poor in 13.42%. There was a very mild fall of 10 mmHg of BP below pre-operative value in 5 patients and two patients complained of headache. Other than these no complications have been encountered. Conclusion: Epidural injection of corticosteroids methyl prednisolone and local anaesthetic lignocaine is an excellent technique for the relief of chronic low back-ache. The side effects are few compared to surgical management. The success rate is high in comparison with other conservative methods. So it can be safely recommended for the relief of low back pain where conservative methods have failed to relieve the pain before embarking on surgical procedure (laminectomy).