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- Title
Epidural steroid injections for low back pain in rural practice: a 5-year retrospective study.
- Authors
Mashari, Azad; Minty, Robert; Minty, Lauren; Hopman, Wilma M.; Kelly, Len
- Abstract
Introduction: Epidural steroid injections (ESIs) are a safe and accessible therapy for chronic low back pain, one of the most common and challenging chronic conditions seen in primary care. However, the indications for and effectiveness of ESI remain controversial. In rural settings with limited public transportation infrastructure, such a mobility-limiting condition can have even more negative effects on quality of life and function. Furthermore, diagnostic and specialist services are often limited. A paucity of safe, effective and accessible treatments leads to heavy reliance on oral analgesics, especially opioids, which have well-known complications. Methods: We reviewed the use of ESI for the 2 most common types of chronic low back pain in those with neurologic symptoms: lumbar disc herniation (LDH) and lumbar spinal stenosis (LSS). We did a retrospective chart review of all patients who underwent ESI between Jan. 1, 2005, and Feb. 25, 2010, at our rural hospital in northwestern Ontario. Results: During the study period, 123 ESIs were administered to 65 patients. After the first injection, 40 patients (62%) reported improvement, 10 (15%) reported worsening or no change, and 15 (23%) had no follow-up documented. Conclusion: Some patients with neurologic compromise from LDH or LSS have improvement in symptoms after ESI. A prospective study is underway to more rigorously assess the effectiveness of this treatment.
- Subjects
EPIDURAL injections; ANALYSIS of variance; LUMBAR pain; CHI-squared test; FISHER exact test; HEALTH outcome assessment; RURAL conditions; T-test (Statistics); TREATMENT effectiveness; RETROSPECTIVE studies; DATA analysis software; DESCRIPTIVE statistics; METHYLPREDNISOLONE
- Publication
Canadian Journal of Rural Medicine (Joule Inc.), 2012, Vol 17, Issue 4, p127
- ISSN
1203-7796
- Publication type
Article