The Outcome of Epidural Injections in Lumbar Radiculopathy Is Not Dependent on the Presence of Disc Herniation on Magnetic Resonance Imaging: Assessment of Short-Term and Long-Term Efficacy

Verheijen, Eduard; Munts, Alexander G.; Haagen, Oscar B.H.A.M. van; Vries, Dirk de; Vleggeert-Lankamp, Carmen L. A.

doi:10.1016/j.wneu.2021.01.051

Cited by 2 publications

(1 citation statement)

References 47 publications

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“…Studies have rarely followed up fibromyalgia patients receiving photobiomodulation therapy for as long as 6 months [ 84 ]. In general, in pain management communities, it is expected that the positive effects of physical treatments do wane with time [ 90 ], even in more discrete, image-diagnosed conditions that encompass locally targeted treatments [ 91 ]. Latest FM guidelines highlight the inconsistent nature of long-term follow-up across a range of pharmacological and physical treatment entities [ 92 ].…”

Section: Discussionmentioning

confidence: 99%

Whole-Body Photobiomodulation Therapy for Fibromyalgia: A Feasibility Trial

Fitzmaurice,

Heneghan,

Rayen

et al. 2023

Behavioral Sciences

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Effective treatment for fibromyalgia (FM) is lacking and further treatment options are needed. Photobiomodulation therapy (PBMT) represents one potential treatment option. Whilst favourable findings have been reported using localised PBMT, no investigations have established the value of whole-body PBMT for the complete set of symptom domains in FM. A single-arm feasibility study was conducted in accordance with CONSORT (Consolidated Standards of Reporting Trials) guidelines. A non-probability sampling method was used to access individuals with FM. The primary outcome measure was identified as the Revised Fibromyalgia Impact Questionnaire (FIQR). Forty-nine participants were screened and twenty-one trial participants entered the trial. Nineteen participants completed the intervention (18 whole-body PBMT sessions over approximately six weeks). Descriptive statistics and qualitative analysis was undertaken to represent feasibility outcomes. Acceptability of the trial device and processes were established. Outcome measures towards efficacy data were guided by core and peripheral OMERACT (outcomes measures in rheumatological clinical trials) domains, utilising a combination of participant-reported and performance-based outcome measures. Data for the embedded qualitative component of the trial were captured by participant-reported experience measures and audio-recorded semi-structured interviews. Positive changes were observed for FM-specific quality of life, pain, tenderness, stiffness, fatigue, sleep disturbance, anxiety, depression and cognitive impairment. Patient global assessment revealed improvements at 6 weeks, with continued effect at 24 weeks. FM-specific quality of life at 24 weeks remained improved compared with baseline scores. The findings provided evidence to support a full-scale trial and showed promise regarding potential efficacy of this novel non-invasive treatment in an FM population.

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Section: Discussionmentioning

confidence: 99%

Whole-Body Photobiomodulation Therapy for Fibromyalgia: A Feasibility Trial

Fitzmaurice,

Heneghan,

Rayen

et al. 2023

Behavioral Sciences

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Caudal epidural steroid injection versus transforaminal ESI for unilateral S1 radiculopathy: a prospective, randomized trial

et al. 2023

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Objective Epidural steroid injections are frequently performed to manage radicular symptoms. Most research investigating the effectiveness of different routes of epidural injections were conducted with non-homogeneous groups. In this study our aim was to investigate the efficacy of caudal versus transforaminal approaches in patients with unilateral S1 radiculopathy secondary to a paracentral L5-S1 disc herniation. Study design Prospective, randomized clinical trial. Setting A university hospital pain management center. Methods The study was conducted between January 2022 and February 2023. Patients with unilateral S1 radiculopathy were randomly divided into two groups: the caudal epidural steroid injection (CESI) and the transforaminal epidural steroid injection (TFESI) group. Severity of pain and disability were assessed with Numeric Rating Scale (NRS-11) and Oswestry Disability Index (ODI) at baseline, 3 weeks, and 3 months after treatment. 50% or more improvement in NRS-11 was defined as treatment success. Fluoroscopy time and doses of exposed radiation were also recorded. Results A total of 60 patients were included in the final analysis (n = 30 for each group). Significant improvement in pain and disability scores was observed at 3rd week and 3rd month compared to baseline (p < 0.001). Treatment success rate at 3rd month was 77% for the CESI group and 73% for the TFESI group without any significant difference between the groups (p = 0.766). Conclusion CESI is equally effective as TFESI in the management of S1 radiculopathy due to a paracentral L5-S1 disc herniation. Both approaches can reduce pain and disability while CESI requires shorter fluoroscopy time and less radiation exposure.

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The Outcome of Epidural Injections in Lumbar Radiculopathy Is Not Dependent on the Presence of Disc Herniation on Magnetic Resonance Imaging: Assessment of Short-Term and Long-Term Efficacy

Cited by 2 publications

References 47 publications

Whole-Body Photobiomodulation Therapy for Fibromyalgia: A Feasibility Trial

Whole-Body Photobiomodulation Therapy for Fibromyalgia: A Feasibility Trial

Caudal epidural steroid injection versus transforaminal ESI for unilateral S1 radiculopathy: a prospective, randomized trial

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