Assessment of Efficacy of Transforaminal Epidural Steroid Injection for Management of Low Back Pain with Unilateral Radiculopathy in Industrial Workers: A Randomized Control Trial

Mondal, Piyali; Goswami, Subrata; Basak, Subhadeep

doi:10.7860/jcdr/2017/26400.10765

Cited by 3 publications

(16 citation statements)

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“…Seven studies, published in 8 references, 52 , 56 , 57 , 61 – 63 , 65 , 66 compared ESIs with usual care. Only 1 study had a low (overall) RoB, 56 the other studies had a high RoB (see RoB summary, Supplemental Digital Content 22, http://links.lww.com/CJP/A781 ).…”

Section: Resultsmentioning

confidence: 99%

Clinical Relevance of Epidural Steroid Injections on Lumbosacral Radicular Syndrome-related Synptoms

Bruijn

Groot

Miedema

et al. 2021

The Clinical Journal of Pain

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Section: Resultsmentioning

confidence: 99%

Clinical Relevance of Epidural Steroid Injections on Lumbosacral Radicular Syndrome-related Synptoms

Bruijn

Groot

Miedema

et al. 2021

The Clinical Journal of Pain

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“…A total of 18 studies were included in this systematic review (Fig. 1) [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35].…”

Section: Searchmentioning

confidence: 99%

“…Five studies used manual therapy or manipulations [19,24,27,29,31]. The frequency and duration of physiotherapy interventions were unreported in seven trials [23,25,29,30,[33][34][35]. Where duration was reported, it ranged from 2 weeks [18] to 6 months [26].…”

Section: Physiotherapy Interventionmentioning

confidence: 99%

“…Substantial interventions involved surgery such as microdiscectomy or discectomy [26,29,[32][33][34][35], or decompression [25,28,31]. One study compared epidural injection with extension exercises [30] and one compared chemonucleolysis disc injection [27] with physiotherapy.…”

Section: Control Interventionmentioning

confidence: 99%

“…Eleven trials compared physiotherapy with substantial control intervention. Nine [26][27][28][29][30][31][32][33]35] were included in the subgroup analysis for pain. There was no difference between physiotherapy and substantial intervention for the outcome of pain in the short (SMD 0.20 [95%CI − 0.27, 0.67] p = 0.39, I 2 = 88%, Fig.…”

Section: Subgroup Analysis On Physiotherapy Versus Substantial Interv...mentioning

confidence: 99%

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How effective are physiotherapy interventions in treating people with sciatica? A systematic review and meta-analysis

et al. 2022

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Purpose Physiotherapy interventions are prescribed as first-line treatment for people with sciatica; however, their effectiveness remains controversial. The purpose of this systematic review was to establish the short-, medium- and long-term effectiveness of physiotherapy interventions compared to control interventions for people with clinically diagnosed sciatica. Methods This systematic review was registered on PROSPERO CRD42018103900. Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL (EBSCO), Embase, PEDro, PubMed, Scopus and grey literature were searched from inception to January 2021 without language restrictions. Inclusion criteria were randomised controlled trials evaluating physiotherapy interventions compared to a control intervention in people with clinical or imaging diagnosis of sciatica. Primary outcome measures were pain and disability. Study selection and data extraction were performed by two independent reviewers with consensus reached by discussion or third-party arbitration if required. Risk of bias was assessed independently by two reviewers using the Cochrane Risk of Bias tool with third-party consensus if required. Meta-analyses and sensitivity analyses were performed with random effects models using Revman v5.4. Subgroup analyses were undertaken to examine the effectiveness of physiotherapy interventions compared to minimal (e.g. advice only) or substantial control interventions (e.g. surgery). Results Three thousand nine hundred and fifty eight records were identified, of which 18 trials were included, with a total number of 2699 participants. All trials had a high or unclear risk of bias. Meta-analysis of trials for the outcome of pain showed no difference in the short (SMD − 0.34 [95%CI − 1.05, 0.37] p = 0.34, I2 = 98%), medium (SMD 0.15 [95%CI − 0.09, 0.38], p = 0.22, I2 = 80%) or long term (SMD 0.09 [95%CI − 0.18, 0.36], p = 0.51, I2 = 82%). For disability there was no difference in the short (SMD − 0.00 [95%CI − 0.36, 0.35], p = 0.98, I2 = 92%, medium (SMD 0.25 [95%CI − 0.04, 0.55] p = 0.09, I2 = 87%), or long term (SMD 0.26 [95%CI − 0.16, 0.68] p = 0.22, I2 = 92%) between physiotherapy and control interventions. Subgroup analysis of studies comparing physiotherapy with minimal intervention favoured physiotherapy for pain at the long-term time points. Large confidence intervals and high heterogeneity indicate substantial uncertainly surrounding these estimates. Many trials evaluating physiotherapy intervention compared to substantial intervention did not use contemporary physiotherapy interventions. Conclusion Based on currently available, mostly high risk of bias and highly heterogeneous data, there is inadequate evidence to make clinical recommendations on the effectiveness of physiotherapy interventions for people with clinically diagnosed sciatica. Future studies should aim to reduce clinical heterogeneity and to use contemporary physiotherapy interventions.

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Recent advances in the pharmacological treatment of chronic pain: a systematic review

Fonseca-Rodrigues,

Almeida,

Pinto-Ribeiro

2024

DOR

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Chronic pain is one of the most important public health concerns, greatly impacting the patients' quality of life and with high societal and economical costs. Despite advances in the understanding of pain mechanisms and the establishment of several strategies to decrease pain severity in patients, there continues to be a substantial proportion of patients who are refractory to the currently available treatments. Recently, novel pharmacological strategies have been developed for the treatment/ management of chronic pain, directed at symptoms and psychological complications of the illness. In this work, we performed a systematic review of the recent advances in pharmacological strategies for chronic pain. For that purpose, we searched a total of four databases (PubMed, Science Direct, Web of Science, and Scopus) for clinical trials testing drugs in patients with chronic pain, completed between the years 2017 and 2021 (1 st January 2017 up to 17 th November 2021). The different treatments were analysed and compared regarding their effectiveness, indications, and side effects. We included 166 studies, which provided information on 46 796 participants, mostly women (64%). This review pools together data on novel drug therapeutic strategies or improved applications of already known drugs, from opioids to monoclonal antibodies, providing researchers and health professionals with tools to ameliorate human chronic pain research and management.

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Assessment of Efficacy of Transforaminal Epidural Steroid Injection for Management of Low Back Pain with Unilateral Radiculopathy in Industrial Workers: A Randomized Control Trial

Cited by 3 publications

References 0 publications

Clinical Relevance of Epidural Steroid Injections on Lumbosacral Radicular Syndrome-related Synptoms

Clinical Relevance of Epidural Steroid Injections on Lumbosacral Radicular Syndrome-related Synptoms

How effective are physiotherapy interventions in treating people with sciatica? A systematic review and meta-analysis

Recent advances in the pharmacological treatment of chronic pain: a systematic review

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