Outcome of Caudal Epidural Injections in Chronic Low Back Pain

Abstract

Background: Low back pain is a common problem. The aim of this study was to find the therapeutic efficacy of caudal epidural injections in chronic low back pain.

Methodology: This descriptive study was conducted at Department of Orthopedics, Khyber Teaching Hospital Peshawar, from January 2009 to October 2009. Patients of 20-70 years age with low back pain not responding to oral medications and physiotherapy were included in the study. Caudal epidural block consisting of 9 ml of bupivacaine 0.5% and 1 ml steroid were given. The initial pain response was assessed using multiple outcome measures which included Numeric Rating Scale, Oswestry Disability Index 2.0, MacNab and Prolo pain assessment criteria. Additional data including short-term effect (1 week) and medium-term effect (3 months), were collected by a structured proforma.

Results: Sixty patients were included in this study with average age 45 years, and male to female ratio of 2.8:1. Significant pain relief (>50%) was demonstrated in 43(71%) of patients and functional status improvement was demonstrated by a reduction of 40% in Oswestry Disability Index score in 49(81%) patients.

Conclusion: Caudal epidural injections of bupivacaine and steroid are effective in patients with chronic function-limiting low back pain.