Outcomes of Epidural Steroid Injections as a Conservative Treatment for Lumbar Spinal Stenosis

Abstract

Background: Lumbar spinal stenosis (LSS) is a degenerative condition characterized by the narrowing of the spinal canal in the lower back, resulting in debilitating symptoms. While surgery is often considered for severe cases, alternative conservative treatments are sought for managing mild to moderate LSS. Epidural steroid injections (ESIs) have emerged as a non-surgical option to improve pain and functional outcomes. Objective: This aims to study the outcomes of rehabilitation approaches, specifically focusing on the use of ESIs as a conservative treatment for LSS. Methods: A prospective study was performed in the Department of Physical Medicine & Rehabilitation, Rajshahi Medical College Hospital, Bangladesh. A total of 33 patients diagnosed with lumbar spinal stenosis (LSS) were randomly assigned in to three groups. Group 1 (n = 13) under- went a 2-week inpatient physical therapy program, group 2 (n = 10)received epidural steroid injections, and group 3 (n = 10) served as the control group. The efficacy and safety of ESIs in LSS management. pain and functional assessment scores, such as the Roland Morris Disability Index (RMDI) and the Nottingham Health Profile (NHP) physical activity subscore, were applied to evaluate the outcomes of the interventions at the end of 2nd week, 1 month, 3 months, and 6 months of the follow up compering with the control group (group 3, without any intervention) Results: At the end of the 2nd week, both the epidural steroid and physical therapy groups exhibited notable improvements in pain and functional parameters, with no significant difference observed between the two treatment groups. Additionally, the control group also showed significant improvements. Conclusion: Epidural steroid injections and physical therapy both seem to be effective in LSS patients up to 6 months of follow-up. It provides short-term pain relief and func- tional improvement. While the long-term efficacy remains uncertain, ESIs can be a valuable component of a comprehensive rehabilitation approach for managing LSS. Careful patient selection, optimal dosing, and close monitoring are essential to maximize the benefits and minimize the risks associated with ESIs. Further research is warranted to clarify the long-term outcomes and refine the utilization of ESIs in the conservative management of lumbar spinal stenosis.