Indian Journal of Physical Medicine and Rehabilitation

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VOLUME 26 , ISSUE 2 ( June, 2015 ) > List of Articles


Effect of Caudal Epidural Steroid Injection in Chronic Low Back Pain due to Prolapse Intervertebral Disc

R Sharma, SY Kothari, BB Thukral, S Chaudhary

Citation Information : Sharma R, Kothari S, Thukral B, Chaudhary S. Effect of Caudal Epidural Steroid Injection in Chronic Low Back Pain due to Prolapse Intervertebral Disc. Indian J Phy Med Rehab 2015; 26 (2):49-52.

DOI: 10.5005/ijopmr-26-2-49

Published Online: 01-06-2015

Copyright Statement:  Copyright © 2015; The Author(s).



Low back pain (LBP) due to disc herniation is a frequent cause of back pain. It is a debilitating condition having enormous medical and socio-economic effects. Epidural injection of steroids has been used to treat LBP for many decades. Despite widespread use and numerous publications there is significant controversy with regards to the medical necessity and indications for epidural injections, hence we planned this study.

Materials and methods

This was a prospective follow-up study. Forty-one patients of confirmed diagnosis of prolapse intervertebral disc (PIVD) were included. Caudal epidural steroid injection (CESI) of 80 mg methylprednisolone acetate diluted in 20 ml of 0.9% saline was given. Outcome was assessed by Numeric Pain Rating Scale (NRS), Oswestry Disability Index (ODI), Straight Leg Raise (SLR) and Modified Schober Test (MST) at baseline, one, three, six and twelve weeks follow-up.


Thirty-seven patients completed the study. Significant improvement in patient's status was observed after CESI, as measured with MST, SLR, NRS and ODI at one and three weeks post injection and the improvement were maintained till 12th week. Eighty-three per cent of patients were satisfied at the end of the study and side-effects reported were mild.


CESI is a simple, safe and cost effective intervention procedure for the treatment of chronic LBP due to PIVD. It provides rapid pain relief and improvement of physical function starting within a week of injection.

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