Abstract
Objective: The purpose of this study was to evaluate the effects of exercises combined with transforaminal epidural steroid injection (TFESI) in patients with lumbar radiating pain. Methods: Among 359 patients who were treated with TFESI for lumbar radiating pain, 118 subjects were eligible and analyzed. The injections were performed for all patients with 20 mg triamcinolone, 1 ml lidocaine (0.5%) and 0.5 ml normal saline. Exercise group (n=45) received TFESI as well as additional stabilization exercise for 30 minute sessions over 3 weeks (three times weekly), while control group (n=73) received TFESI and did not receive any additional stabilization exercise. The effects were evaluated using Numercal Rating Scale (NRS) at pre-injection, 4 weeks, 8 weeks, 12 weeks and 24 weeks after injection. Results: Between Exercise and Control group, there were no significant differences in sex, age and baseline NRS score (P>0.05). Compared with that of the baseline, mean NRS scores decreased significantly in both groups after 4 weeks. The improvement sustained until 24 weeks in exercise group, while mean NRS scores slightly increased in control group. The proportion of treatment success at 24 weeks were 68.9% in exercise group and 41.1% in control group (p<0.05, odds ratio=3.17). The exercise group had moderate effect size (d=0.568) compared to the control group at 24 weeks. Conclusion: Lumbar stabilization exercise combined with TFESI was more effective than TFESI alone for reducing lumbar radiating pain and reduced the rate of recurrence.
Highlights
Transforaminal epidural steroid injections (TFESI) are minimally invasive and safe for treating lumbar radiating pain, and it's popularity is growing among physicians [1]
Many studies have demonstrated the effect of lumbar stabilization exercise on pain relief and normal performance [5,6,7,8,9], most of the studies were focused on patients with chronic non-specific low back pain, but not acute back pain caused by herniated lumbar disc
We found that the combination therapy was significantly more effective at 8 weeks, 12 weeks and 24 weeks compared to conventional TFESI alone
Summary
Transforaminal epidural steroid injections (TFESI) are minimally invasive and safe for treating lumbar radiating pain, and it's popularity is growing among physicians [1]. Only 25-57% of patients showed long-term relief [3] For this reason, additional treatments are required to maximize the effects of TFESIs and prevent symptoms from recurring. Lumbar stabilization exercise is more effective in reducing recurrence for patients with low back pain than other conservative measures [4]. Many studies have demonstrated the effect of lumbar stabilization exercise on pain relief and normal performance [5,6,7,8,9], most of the studies were focused on patients with chronic non-specific low back pain, but not acute back pain caused by herniated lumbar disc. There is only one study that states stabilization exercises to be more effective on ADL performance in patients with herniated lumbar disc than no treatment during the short-term follow-up [12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: International Journal of Physical Medicine & Rehabilitation
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
