Does pain score in response to a standardized subcutaneous local anesthetic injection predict epidural steroid injection outcomes in patients with lumbosacral radiculopathy? A prospective correlational study

Steven Cohen, Jianren Mao, To Nhu Vu, Scott A. Strassels, Anita Gupta, Michael Erdek, Paul Christo, Connie Kurihara, Scott R. Griffith, Chester C. Buckenmaier, Lucy Chen

Research output: Contribution to journalArticle

Abstract

Objective: Epidural steroid injections (ESI) are the most commonly performed pain procedures. Despite numerous studies, controversy continues to surround their effectiveness. The purpose of this study is to determine whether a standard, clinical local anesthetic injection can predict outcomes for ESI. Study Design: In this multicenter study, 103 patients received two ESI 2 weeks apart. Prior to their first injection, subjects rated the pain intensity of a standardized subcutaneous (SQ) injection of lidocaine prior to the full dose. Numerical rating scale pain scores were correlated with leg and back pain relief, and functional improvement, through 3-month follow-up. Outcome Measures: A composite successful outcome was predetermined to be a ≥2-point decrease in leg pain score, coupled with a positive global perceived effect. Results: A small but significant relationship was found between SQ pain score and reduction in leg (r=-0.21, 95% CI -0.38 to -0.04; P=0.03) and back pain (r=-0.22, 95% CI -0.36 to -0.07; P=0.03). Subjects with a positive outcome at 1 month had a mean SQ pain score of 2.5 (SD 1.9) vs 4.1 (SD 2.7) in those with a negative outcome (P=0.04). Subjects with SQ pain scores

Original languageEnglish (US)
Pages (from-to)327-335
Number of pages9
JournalPain Medicine
Volume14
Issue number3
DOIs
StatePublished - Mar 2013

Fingerprint

Epidural Injections
Radiculopathy
Local Anesthetics
Steroids
Prospective Studies
Pain
Injections
Leg
Back Pain
Subcutaneous Injections
Lidocaine
Multicenter Studies
Outcome Assessment (Health Care)

Keywords

  • Clinical Stimulus
  • Epidural Steroid Injection
  • Lumbosacral Radiculopathy
  • Predictive Value
  • Sciatica
  • Subcutaneous Injection

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

Does pain score in response to a standardized subcutaneous local anesthetic injection predict epidural steroid injection outcomes in patients with lumbosacral radiculopathy? A prospective correlational study. / Cohen, Steven; Mao, Jianren; Vu, To Nhu; Strassels, Scott A.; Gupta, Anita; Erdek, Michael; Christo, Paul; Kurihara, Connie; Griffith, Scott R.; Buckenmaier, Chester C.; Chen, Lucy.

In: Pain Medicine, Vol. 14, No. 3, 03.2013, p. 327-335.

Research output: Contribution to journalArticle

Cohen, Steven ; Mao, Jianren ; Vu, To Nhu ; Strassels, Scott A. ; Gupta, Anita ; Erdek, Michael ; Christo, Paul ; Kurihara, Connie ; Griffith, Scott R. ; Buckenmaier, Chester C. ; Chen, Lucy. / Does pain score in response to a standardized subcutaneous local anesthetic injection predict epidural steroid injection outcomes in patients with lumbosacral radiculopathy? A prospective correlational study. In: Pain Medicine. 2013 ; Vol. 14, No. 3. pp. 327-335.
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