Chronic back pain is spread from neck to sacrum. The upper back pain is caused by cervical vertebrae and spinal cord diseases. Similarly mid back and lower back pain are caused by thoracic and lumbar vertebrae and spine.
Most Common Causes Of Back Pain In Upper, Middle Or Lower Back Are As Follows-
- Lumbar Disk Bulge
- Lumbar Disk Herniation
- Lumbar Spinal Stenosis
- Lumbar Radiculopathy
- Lumbar Spinal Stenosis.
Pain is intense and often does not respond to conservative treatment or medications. Physical therapy may relieve pain for short period of time. Alternatively patients are advised to try lumbar epidural steroid injection. Lumbar epidural steroid injection is performed for lower back pain since Second World War. Epidural injection is performed either as a diagnostic procedure or therapeutic procedure.
Diagnostic injection is performed once and therapeutic injections are repeated several times in a year. Various anesthesiology and pain associations publish the guidelines for therapeutic epidural injections. Guideline suggests 3 epidural injections are to be performed within first 3 months. Following first 3 epidural injections depending on length of pain relief and benefits of treatment follow up one injection is scheduled between 3 to 4 months.
Recently Chan-Hong Park MD, PhD and Sang-Ho Lee MD, PhD published a scientific paper titled as "Correlation Between Severity of Lumbar Spinal Stenosis and Lumbar Epidural Steroid Injection".
The paper was published dated January 16, 2014 in the Scientific Journal Pain Medicine. Study had included 47 patients suffering with degenerative lumbar spinal stenosis. Each patient had one epidural injection and patients were evaluated at the end of 2 and 6 weeks following injection. Over 75% patient had satisfactory pain relief at the end of 6 week and study concluded epidural injection helps to relieve pain for 6 week.
There are several other studies performed in the past evaluating benefits of series of 3 to 4 epidural steroid injections resulting in pain relief lasting 3 to 6 months. Studies have suggested epidural steroid injection has prevented back surgery in significant cases.1 Multi-Center double blind study had evaluated effectiveness of epidural steroid injection and out come suggest epidural steroid injection improves pain and improves function in patient suffering with lumbar spinal stenosis.
1. Epidural steroids: a comprehensive, evidence-based review.
Cohen SP, Bicket MC, Jamison D, Wilkinson I, Rathmell JP.
Reg Anesth Pain Med. 2013 May-Jun;38(3):175-200. doi: 10.1097/AAP.0b013e31828ea086.
2. Study protocol- Lumbar Epidural steroid injections for Spinal Stenosis (LESS): a double-blind randomized controlled trial of epidural steroid injections for lumbar spinal stenosis among older adults.
Friedly JL, Bresnahan BW, Comstock B, Turner JA, Deyo RA, Sullivan SD, Heagerty P, Bauer Z, Nedeljkovic SS, Avins AL, Nerenz D, Jarvik JG.
BMC Musculoskelet Disord. 2012 Mar 29;13:48. doi: 10.1186/1471-2474-13-48.