EPIDURAL STEROID INJECTION IN PATIENTS WITH LOW BACK PAIN DUE

Low back pain is a common and debilitating disorder. Current evidence implicates intervertebral disc (IVD) degeneration and herniation as major causes (Le Maitre et al., 2007). Chronic lumbar radicular pain is mostly due to discopathy (Atcheson et al., 2004).Non surgical treatment of discogenic pain : (Bed rest ,Lumbar corset ,Oral medication , Physical therapy , Epidural steroids injection(ESI) (Barendse et al., 2001) .Intravenous infusion of infliximab or subcutaneous perispinal administration of Etanercept was associated with dramatic response (Tobinick and Davoodifar ,2004). A Stem cell transplantation (Acosta et al., 2005).Improvements may be explained in part based on the pharmacological and physical actions of local anesthetics, corticosteroids, and other agents (Boswellet al., 2007)Various types of injection techniques have been described (caudal –transforaminal- interlaminar) with multiple benefits including pain relief that outlasts by days, weeks, or months. (Boswell et al., 2007).CONCLUSIONEpidural steroid injections (ESIs) have been endorsed as an integral part of nonsurgical management of back and radicular pain from lumbar spine disorders. They are best performed under fluoroscopic visualization.