Comparison of two doses of corticosteroid in epidural steroid injection for lumbar radicular pain

Owlia MB, Salimzadeh A, Alishiri Gh, Haghighi A
Correspondence: Dr Mohammad  Bagher Owlia, mbowlia2@yahoo.com

ABSTRACT
Introduction Low back pain and lumbar radicular pain are the leading causes of job loss worldwide. Therapeutic approaches to lumbar radicular pain, including sciatica and spinal canal stenosis, are diverse. Many clinicians use 80 mg long-acting glucocorticoids in epidural steroid injections (ESI). The aim of this study is to compare the clinical response of 80 mg versus 40 mg methylprednisolone in ESI.
Methods 84 patients with newly exacerbated lumbar radicular pain were randomly al located into two groups. 43 patients underwent ESI with 80 mg Depo-Medrol and 41 age- and sex-matched cases received 40 mg Depo-Medrol as the comparison group. The pain in the second week, and every month thereafter was assessed using a visual analogue scale (VAS).
Results Remarkable improvement in one month VAS occurred in 64 cases (75 percent) from both groups. VAS values between 80 mg and 40 mg groups were comparable in the two-week (p-value is 0.827) and three-month (p-value is greater than 0.746) post-injection periods. Slightly better results were shown in patients in the 40 mg group after one month.
Conclusion In the case of lumbar radicular pain, ESI with low dose (40 mg) methylprednisolone is as effective as high dose (80 mg) with comparable results and less adverse profile.

Keywords: epidural injection, glucocorticoid, herniated disc, radicular pain, steroid injection
Singapore Med J 2007; 48(3): 241–245