Factors Associated With Pain Reduction After Transforaminal Epidural Steroid Injection for Lumbosacral Radicular Pain
| Autor: | Zachary L McCormick, Christopher T. Plastaras, Cynthia Garvan, Ellen Casey, David J. Kennedy, Daniel M. Cushman |
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| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
Visual analogue scale medicine.medical_treatment Anti-Inflammatory Agents Injections Epidural Physical Therapy Sports Therapy and Rehabilitation Physical examination Walking Triamcinolone Betamethasone Severity of Illness Index Predictive Value of Tests Surveys and Questionnaires medicine Back pain Humans Radiculopathy Pain Measurement Neurologic Examination medicine.diagnostic_test Epidural steroid injection business.industry Rehabilitation Lumbosacral Region Retrospective cohort study medicine.disease Stenosis Radicular pain Anesthesia Physical therapy medicine.symptom Spinal Nerve Roots business Low Back Pain Femoral Nerve Lumbosacral joint |
| Zdroj: | Archives of Physical Medicine and Rehabilitation. 95:2350-2356 |
| ISSN: | 0003-9993 |
| Popis: | Objective To identify demographic and clinical factors associated with pain improvement after a lumbosacral transforaminal epidural steroid injection (TFESI) for the treatment of radicular pain. Design Retrospective cohort study. Setting Outpatient center. Participants Adults (N=188) who underwent a fluoroscopically guided TFESI for lumbosacral radicular pain. Interventions Not applicable. Main Outcome Measures Pain reduction from preinjection to 2-week follow-up was measured by visual analog scale (VAS). Patients were grouped by those who experienced no pain relief or worsened pain (≤0%), pain relief but 0%– Results The mean duration of pain prior to injection was 45.8±81 weeks. The mean time to follow-up after TFESI was 20±14.2 days. Significantly more patients who experienced ≥50% pain relief at follow-up reported higher preinjection pain on the VAS ( P =.0001) and McGill Pain Inventory Questionnaire ( P =.0358), reported no worsening of their pain with walking ( P =.0161), or had a positive femoral stretch test ( P =.0477). No significant differences were found between VAS pain reduction and all other demographic and clinical factors, including a radiologic diagnosis of disk herniation versus stenosis or other neural tension signs on physical examination. Conclusions Greater baseline pain on the VAS and McGill Pain Inventory, a history of a lack of worsening pain with walking, and a positive femoral stretch test predict a greater likelihood of pain reduction after TFESI for lumbosacral radicular pain at short-term follow-up. Greater baseline pain on the McGill Pain Inventory and a lack of worsening pain with walking predict a magnitude of >50% pain reduction. |
| Databáze: | OpenAIRE |
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