Disclosures: Valentine U. Chukwuma, PhD: No financial relationships or conflicts of interest
Objective : To determine when patients could reasonably expect to experience pain relief following an epidural steroid injection (ESI).
Design: Prospective cohort of consecutive patients.
Setting : Large academic medical center.
Participants : Any patient scheduled for an epidural steroid injection over a 3-month period met inclusion criteria. Exclusion criteria were under 18 years of age, ESI within the past 6 months or any steroid injection within the past 8 weeks. Patients who received a repeat ESI during the study period were not considered for reenrollment.
Interventions: Patients were contacted every 3 days +/- 1 day for 21 days post injection to assess pain as measured via 11-point numeric pain score, and subjective percentage pain relief question.
Main Outcome Measures: Patient experiencing greater than 50% pain relief after the ESI.
Results: 42 patients were enrolled. In total 26 patients achieved 50% reduction in pain. Of these, 21/26 (80%) reported duration of relief lasted through completion of the study. 23/26 patients that achieved 50% pain relief first reported this on day 4 post ESI, compared to 3/26 (12%) who first experienced >50% relief after 4 days; specifically, 1/26 on day 7 post ESI, and 2/26 on day 13 post ESI.
Conclusions: The findings from this study show that a majority of the patients who experience >50% relief after an ESI do so by 4 days post injection. This study is ongoing, but interim analysis calls into question the common belief that effects of ESI may take up to 2 weeks to become apparent. Interestingly, of the patients who experienced pain relief initially, most continued to report pain relief at day 21. This confirms that a scheduled repeat ESI within 21 days is not routinely needed.
Level of Evidence: Level III
To cite this abstract in AMA style:
Chukwuma VU, Schneider B. Assessing Timeline of Patient Response to Steroid Epidural Injection for Pain [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/assessing-timeline-of-patient-response-to-steroid-epidural-injection-for-pain/. Accessed September 7, 2024.« Back to AAPM&R Annual Assembly 2020
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/assessing-timeline-of-patient-response-to-steroid-epidural-injection-for-pain/