Abstract 2: Efficacy of epidural steroid injections

Objectives: To test the efficacy of epidural steroid injections (ESIs) for the relief of radicular-, facet joint-, and lumbar stenosis-related pain 3 months postinjections and to demonstrate whether the presence of litigation and smoking influenced the response to treatment. Design: Prospective survey. Setting: Community-based hospital. Participants: 300 patients who received steroid injections for radicular-, facet joint-, and lumbar stenosis-related pain. Interventions: All participants had clinical and diagnostic evidence of lumbar radiculopathy, spinal stenosis, or facet pain. Each was then treated with a series of ESIs. Each patient filled out a preinjection survey to determine the duration and distribution of their pain. A 10-point analog pain scale determined their pre-injection pain. Factors also evaluated were the etiology of pain, the presence of a lawsuit, and if the patient was a habitual smoker. At 3 months postinjection, each participant received a survey to rate their current pain and declare other interventions such as physical therapy and surgery. Main Outcome Measures: Percentage of participants who received pain relief from their ESIs and specifically which etiology of back pain showed a better response. Results: 3 months after ESIs, approximately 80% of patients had a decrease in their symptoms by 2 or more points on the 10-point analog pain scale. Patients who experienced the most pain relief were those with radicular or stenotic symptoms, nonsmoking, or without concomitant litigation. Conclusion: Steroid injections for back pain of radicular or stenotic nature (not facet), especially for nonsmokers or those without litigation, are an effective means of treating low back pain (LBP) in the first 3 months. This study will be followed by a 6 month and 12 month survey to determine the long-term efficacy of steroid injections for LBP.