Pain reproduction during lumbosacral transforaminal epidural steroid injection does not affect outcome.

Objective: Epidural steroid injections (ESIs) are widely used in clinical practice for the treatment of low back radicular pain. Anecdotally it has been conveyed that the reproduction of a patient's usual pain during ESI was of prognostic value as to which patients would show favorable results from the procedure, however, there is no data available to support this supposition. Design: Retrospective. Setting: Outpatient Spine and Sports Medicine Clinic. Patients: Patients with lumbosacral radicular pain treated with fluoroscopically guided contrast enhanced lumbosacral transforaminal ESI. Outcome Measures: 11-point pain intensity numeric rating scale (PI-NRS). Results: Overall the procedure provided statistically significant pain relief in both groups A (typical radicular pain reproduced) and B (typical radicular pain not reproduced) immediately and significant pain reduction was maintained until the time of the follow-up No reduction in pain was seen in group A vs. B, although in group B there was a strong trend toward having higher pain scores at all times. Conclusion: The reproduction of a patient's typical radicular pain during a fluoroscopically guided contrast enhanced lumbosacral transforaminal ESI does not predict a significant decrease in pain scores immediately after the procedure or at follow up. [ABSTRACT FROM AUTHOR]