Clin Orthop Surg.  2016 Sep;8(3):262-267. 10.4055/cios.2016.8.3.262.

The Effectiveness of Oral Corticosteroids for Management of Lumbar Radiating Pain: Randomized, Controlled Trial Study

Affiliations
  • 1Department of Orthopaedic Surgery, Daegu Catholic University Medical Center, Daegu, Korea. bong@cu.ac.kr

Abstract

BACKGROUND
Although both pregabalin and gabapentin are known to be useful for treating lumbar radiating pain and reducing the incidence of surgery, the oral corticosteroids sometimes offer a dramatic effect on severe radiating pain despite the lack of scientific evidence.
METHODS
A total of 54 patients were enrolled among 703 patients who complained of lumbar radiating pain. Twenty patients who received an oral corticosteroid was classified as group A and 20 patients who received the control drugs (pregabalin or gabapentin) as group B. Oswestry Disability Index (ODI), Revised Roland Morris disability questionnaire (RMDQ), Short Form 36 (SF-36) questionnaire, lumbar radiating pain, objective patient satisfaction, and objective improvement of patients or physicians were assessed at 2, 6, and 12 weeks after medication.
RESULTS
No difference in the sex ratio and age was observed between the groups (p = 0.70 and p = 0.13, respectively). Group A showed greater improvement in radiating pain after 2, 6, and 12 weeks than group B (p < 0.001, p = 0.001, and p < 0.001, respectively). No differences were observed between the groups in satisfaction at the beginning and 12 weeks after taking the medication (p = 0.062 and p = 0.061, respectively) and in objective improvement of patients and physicians (p = 0.657 and p = 0.748, respectively). Group A was less disabled and had greater physical health scores than group B (p = 0.014 and p = 0.017, respectively).
CONCLUSIONS
Oral corticosteroids for the treatment of lumbar radiating pain can be more effective in pain relief than gabapentin or pregabalin. The satisfaction of patients and physicians with the drug and objective improvement status were not inferior to that with gabapentin or pregabalin.

Keyword

Radiculopathies; Corticosteroids; Gabapentin; Pregabalin

MeSH Terms

Adolescent
Adrenal Cortex Hormones/*therapeutic use
Adult
Aged
Amines/therapeutic use
Analgesics/therapeutic use
Cyclohexanecarboxylic Acids/therapeutic use
Female
Humans
Low Back Pain/*drug therapy/*physiopathology
Lumbosacral Region/physiopathology
Male
Middle Aged
Patient Satisfaction/statistics & numerical data
Pregabalin/therapeutic use
Quality of Life
Radiculopathy/drug therapy
Surveys and Questionnaires
Young Adult
gamma-Aminobutyric Acid/therapeutic use
Adrenal Cortex Hormones
Amines
Analgesics
Cyclohexanecarboxylic Acids
Pregabalin
gamma-Aminobutyric Acid

Figure

  • Fig. 1 Flow diagram showing the procedure used in the study. LANSS: Leeds Assessment of Neuropathic Symptoms and Signs, VAS: visual analogue scale.


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