Efficacy of ultrasound-guided caudal epidural steroid injection for axial or radicular low back pain: a retrospective cross-sectional study

Background and objective: Ultrasound (USG)-guided caudal epidural steroid injections (CESI) have the advantage of being more easily applicable without radiation exposure. However, there is limited evidence regarding their use in the treatment of lumbar disc herniation, and no data is available regarding patient satisfaction. The aim of this study is to evaluate the effect of USG-guided CESI on axial or radicular low back pain.
Methods: This study was designed as a retrospective case-control study conducted in an outpatient setting at a tertiary care hospital. Records of the 21 patients who underwent USG-guided CESI due to axial or radicular low back pain and had an assessment with a visual analog scale (VAS pain), degree of pain relief, patient satisfaction scale, sleep quality, and Roland Morris Disability Questionnaire (RMDQ) in the patient files or electronic database were included in the study between December 2022 and May 2023.

Results: There was a significant difference in VAS pain scores between admission and the 2nd week and between admission and the 6th week (p<0.001). The frequency of meaningful pain reduction accepted as more than 50% pain relief was 57.1% and 38.1% at the 2nd and 6th weeks, respectively. A significant difference was found in RMDQ scores between admission and the 2nd week, between admission and the 6th week (p<0.001), and between the 2nd week and the 6th week (p = 0.447). While 71.4% of the patients described poor sleep at presentation, this ratio was 19.0% and 23.8% at the 2nd and 6th weeks, respectively. While 91.5% of the patients declared that they were better in the 2nd week, 71.4% reported that they were better in the 6th week.
Conclusion: Ultrasonography-guided CESI is an effective treatment method for improving pain, sleep quality, and disability by ensuring high patient satisfaction in individuals with axial or radicular low back pain in a short-to-moderate-term follow-up.