Factors influencing the pain relief obtained with epidural methylprednisolone in low-back pain and sciatica

Abstract

One hundred and twenty-four patients suffering from low-back pain were allocated to two groups: a study group comprised of 104 patients to be treated with epidural Depomedrol (methylprednisolone depot) in saline and a control group of 20 patients who were to be given only saline. Seventy-nine patients (75.3 per cent) in the study group showed good relief of pain in comparison with five patients (25 per cent) in the control group, a statistically significant difference (P ≤ 0.05). Patients with localized pathology responded better (86.5 per cent) than those with generalized pathology (65.4 per cent). Response was also better in patients in whom the pain was of an acute (84.6 per cent) rather than chronic (48 per cent) nature (P ≤ 0.05). The caudal route of medication had an edge over the lumbar epidural one as 87 per cent showed good relief. A higher concentration of drug (8 mg/ml) showed slightly better but statistically insignificant (P ≤ 0.05) relief of pain. Thirty-six (34.6 per cent) patients who were given epidural methylprednisolone showed pain relief lasting for more than 1 year.