The Role of Caudal Epidural Steroid Injections in Management of Low Back Pain

Abstract

The role of caudal epidural steroid injection in management of low back pain is controversial. This is a prospective study done on 50 patients who reported to orthopaedic OPD over a period of 2 years. Patients were classified on the basis of MRI diagnosis. All the injections were given by same surgeon after a trial of conservative treatment for at least six weeks. A combination of drugs containing methylprednisolone, lignocaine 2% and normal saline was injected through sacral hiatus. Patients were assessed at 24 hours, one week, three weeks and three months interval. No major complications were observed except for dural leak, headache and injection site pain. We believe that CEI is mainly effective in treating patients with acute low back pain refractory to conservative treatment, patients with disc degeneration and discogenic grade I -II low back pain. The patients with chronic pain usually do not respond to CEI on long term follow up. Such patients must be referred to back school condition programs before taking up for surgery.