Sciatica after intra articular corticosteroids injection

Abstract

Background. The intra-articular cortico-steroid (IA-CS) injections treatment are still debatable despite its effectiveness. The failure can cause sciatica which IA-CS injected at the sacroiliac joint (SIJ). The study was done to determine non-technical factors that cause recurrent LBP after optimal SIJ IA-CS injections. Methods. A prospective-clinical study was done that looked at recurring sciatica variables in the cases that received intra-articular injection of CS. Cases were diagnosed with sciatica according to the IASP criteria. All patients had intra-articular CS injections. The numerical rating scale (NRS) was used for rating the pain in the SIJ on a range of (0-10). The scale was reviewed 3, 6, and 9 months post treatment. Age, gender, BMI, trauma history, long-term standing, NSAID used and knee pain were all documented as intra-articular injection treatment possible failure factors. Results. In total, 50 subjects were enrolled, with more females (60%) than males (40%). The mean of age was 55.8±7.4 years. History of trauma was reported in 60%. Long sitting and standing history presented in 70% and 20%, respectively. The recurrence of sciatica affected 30(60%) patients. The right sciatica was affecting more than half of the cases (60%). The vast majority of cases (80%) used NSAID. The pain began within the last three months in 80% of the patients. History of CS injection was recorded in 38% of the cases. Lower limb pain was reported in 80% of the cases. Cases with and without recurrence had the mean age of 55.9 ± 9.5 years and 50.6 ± 14.9 years, respectively. The SIJ pain recurrence is strongly connected with elderly and long sitting in logistic regression analysis. Conclusions. Elderly, NSAID utilize, and uni-lateral sciatica involvement are protective factors against SIJ discomfort recurrence.