J Med Life Sci.  2025 Jan;22(1):16-21. 10.22730/jmls.2025.22.1.16.

Summary of recommendations of pain intervention for low back pain with radiculopathy

• Huh J
• Choi YS
• Chung YN

• KMID: 2564088
• DOI: http://doi.org/10.22730/jmls.2025.22.1.16

Abstract

To aid in the selection of rationalized pain intervention modalities for low back pain (LBP), treatment guidelines were identified through a systematic search of the MEDLINE electronic database. Structured guidelines from four groups (North American Spine Society [NASS], American Society of Interventional Pain Physicians [ASIPP], American Pain Society/American College of Physicians [APS/ACP], and European), were selected for their detailed reviews of each pain intervention technique. Current popular intervention techniques and their supporting evidence based on recommendations for LBP with radiculopathy were summarized and compared. All guidelines, except those from the European group, endorsed the effectiveness of epidural injections for radicular pain caused by herniated discs and spinal stenosis. Lumbar epidural adhesiolysis was found to be effective for managing spinal stenosis and failed back surgeries. However, intradiscal electrothermal therapy and coblation nucleoplasty showed weak evidence for recommendation. Furthermore, the APS/ACP and European groups advised against the use of intradiscal steroid or glycerol injections for lumbar disc herniation. It is important to select an effective pain intervention technique, because LBP with radiculopathy is a prevalent condition in clinical practice. Consequently, referring to evidence-based guidelines and recommendations is essential to ensure rationalized and effective treatment choices.

Keyword

Back; Guideline; Pain; Radiculopathy; Therapeutics