The Efficacy of Lumbar Stabilization Exercise Combined with Transforaminal Epidural Steroid Injection for Lumbar Radiating Pain

Abstract

Objective: The purpose of this study was to evaluate the effects of exercises combined with transforaminal epidural steroid injection (TFESI) in patients with lumbar radiating pain. Methods:Among 359 patients who were treated with TFESI for lumbar radiating pain, 118 subjects were eligible and analyzed. The injections were performed for all patients with 20 mg triamcinolone, 1 ml lidocaine (0.5%) and 0.5 ml normal saline. Exercise group (n=45) received TFESI as well as additional stabilization exercise for 30 minute sessions over 3 weeks (three times weekly), while control group (n=73) received TFESI and did not receive any additional stabilization exercise. The effects were evaluated using Numercal Rating Scale (NRS) at pre-injection, 4 weeks, 8 weeks, 12 weeks and 24 weeks after injection.Results: Between Exercise and Control group, there were no significant differences in sex, age and baseline NRS score (P>0.05). Compared with that of the baseline, mean NRS scores decreased significantly in both groups after 4 weeks. The improvement sustained until 24 weeks in exercise group, while mean NRS scores slightly increased in control group. The proportion of treatment success at 24 weeks were 68.9% in exercise group and 41.1% in control group (p<0.05, odds ratio=3.17). The exercise group had moderate effect size (d=0.568) compared to the control group at 24 weeks. Conclusion:Lumbar stabilization exercise combined with TFESI was more effective than TFESI alone for reducing lumbar radiating pain and reduced the rate of recurrence.

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