Effects of epidural injection of glucocorticoid and its combination with bupivacaine in palliating chronic low back pain due to discopathy

Abstract

Chronic low back pain is defined as consistent or pendulous pain over 3 months. Epidural steroid injections (ESI) are common in treatment of chronic back pain. The present study was aimed to investigate the effects of epidural injection of glucocorticoid and bupivacaine compared to glucocorticoid alone in relieving chronic back pain due to discopathy. A randomized clinical trial was performed in the Shohada Medical Educational Center, Tabriz, Iran. Patients with chronic back pain who were candidates for epidural drug injection were recruited. They were divided into two groups of steroids or steroid and bupivacaine. Pain intensity, Oswestry Disability Index (ODI), Straight Leg Rising (SLR) test as well as clinical variables were evaluated before treatment and 3th month thereafter. Overall, 17 males and 23 females with a mean age +/- SD of 47.54 +/- 12.11 years were enrolled in two equal groups. No significant difference was observed between two groups in terms of gender and body mass index. In both groups, a significant relationship was observed for ODI (p=0.001), pain intensity (p=0.001), and SLR test (p=0.001) before and after treatment. However, the corresponding association was not observed for ODI, pain intensity and SLR test (p>0.05). Epidural steroid injections either alone or combined with Bupivacaine with no priority are effectively relief chronic low back pain due to discopathy.