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Transforaminal steroid injection for lumbar radicular pain proves superior to placebo
Date:7/29/2010

A recent study from Australian researchers determined that transforaminal injection of steroids was a viable alternative to surgery for lumbar radicular pain due to disc herniation. Full details of the study appear in the August issue of Pain Medicine, a journal published by Wiley-Blackwell on behalf of the American Academy of Pain Medicine, the Faculty of Pain Medicine of the Australian and New Zealand College of Anaesthetists, and the International Spine Intervention Society.

Lumbar radicular pain (sciatica) is most commonly caused by lumbar disc herniation and inflammation of the affected nerve roots. Injections of steroids by various routes are used as an alternative to surgery to reduce the inflammation and relieve the pain. Epidural steroid injection, by either the interlaminar or caudal route, is the most widely used steroid treatment for pain relief. However, studies indicate that interlaminar injections are no more effective than normal saline injections into an interspinous ligament, while caudal epidural injections of steroids have failed to prove superior to local anaesthetic alone.

Transforaminal injectionthe injection of steroids directly and accurately onto the affected spinal nerve under radiologic guidancehas proved more effective than interlaminar injection of steroids with respect to pain relief and improvement of disability. However, controlled studies of this method of administration produce conflicting results.

The present study examined whether the transforaminal route of injection or the agent injected is the critical element in determining successful pain relief. Study participants were randomized into one of five groups: Transforaminal injection of steroids (TFST) to test its effectiveness; transforaminal injection of normal saline (TFNS) to test for an irrigation effect; transforaminal injection of local anesthetic (TFLA) to test the effect of a local anesthetic; intramuscular injection of steroids (
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Contact: Dawn Peters
healthnews@wiley.com
781-388-8408
Wiley-Blackwell
Source:Eurekalert

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