Pain Management

Chronic Pain Management

A Randomized, Controlled, Double-Blind Trial of Fluoroscopic Caudal Epidural Injections in the Treatment of Lumbar Disc Herniation and Radiculitis

Manchikanti L, Singh V, Cash KA, et al (Pain Management Ctr of Paducah, KY; Pain Diagnostics Associates, Niagara, WI; et al) Spine 36:1897-1905, 2011^§

Abstract

Study Design

A randomized, controlled, double-blind trial.

Objective

To assess the effectiveness of fluoroscopically directed caudal epidural injections in managing chronic low back and lower extremity pain in patients with disc herniation and radiculitis with local anesthetic with or without steroids.

Summary of Background Data

The available literature on the effectiveness of epidural injections in managing chronic low back pain secondary to disc herniation is highly variable.

Methods

One hundred twenty patients suffering with low back and lower extremity pain with disc herniation and radiculitis were randomized to one of the two groups: group I received caudal epidural injections with an injection of local anesthetic, lidocaine 0.5%, 10 mL; group II patients received caudal epidural injections with 0.5% lidocaine, 9 mL, mixed with 1 mL of steroid.

The Numeric Rating Scale (NRS), the Oswestry Disability Index 2.0 (ODI), employment status, and opioid intake were utilized with assessment at 3, 6, and 12 months posttreatment.

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