Session Information
Session Title: AA 2022 Posters - Pain and Spine Medicine
Session Time: None. Available on demand.
Disclosures: Tomasz Chec, MD: No financial relationships or conflicts of interest
Background and/or Objectives: Epidural steroid injections (ESI) and opioids are commonly used treatments for patients experiencing pain following an acute disc herniation. However, opioid use for short term pain carries significant risk for long-term use and dependence. The purpose of this study is to assess if early ESI helps decrease opioid use duration in patients with acute radicular pain from a disc herniation.
Design: Retrospective Cohort Study
Setting: Single multi-specialty orthopaedic practice
Participants: All patients that underwent ESI at a single institution in 2016 and 2017 by 5 fellowship-trained physiatrists, using a combination of CPT and ICD-10 codes. Patient charts were evaluated to identify only patients with symptoms ranging from 2-12 weeks prior to ESI, symptoms of radicular pain, and the confirmation of disc herniation on imaging. Patients with more than 3 months of continuous pre-injection opioid use were excluded.
Interventions: Epidural steroid injection
Main Outcome Measures: Opioid prescription data, including fill date, number of pills, and milligram morphine equivalent (MME) per prescription, was collected with the Pennsylvania Prescription Drug Monitoring Program (PDMP) before and up to 6 months following ESI.
Results: A total of 242 patients met inclusion criteria and received an opioid prescription within 6 months before or after injection (81 with symptoms less than 6 weeks prior to injection, 161 with symptoms 6-12 weeks prior to injection). The percentage of patients that decreased total opioid prescriptions at 1, 2, and 3 months was 63.2%, 55.7%, and 53.5% respectively. There was no significant difference between the patients with symptoms < 6 weeks and 6-12 weeks prior to injection. Over 40% of patients in each timeframe stopped opioid use completely following ESI.
Conclusions: Early ESI for radicular symptoms from acute disc herniation led to a reduction in opioid prescriptions for the majority of patients in this study, regardless of time of symptom onset prior to injection.
Level of Evidence: Level III
To cite this abstract in AMA style:
Chec T, Gehret J, Simon JI, Stolzenberg D, Greis A, Sharma S, Plusch K, Bloom E, Rengifo S, Ilyas A. Does Time to Procedure of Epidural Steroid Injection Affect Duration of Opioid Use During an Acute Episode of Radicular Pain from Disc Herniation? [abstract]. PM R. 2022; 14(S1)(suppl 1). https://pmrjabstracts.org/abstract/does-time-to-procedure-of-epidural-steroid-injection-affect-duration-of-opioid-use-during-an-acute-episode-of-radicular-pain-from-disc-herniation/. Accessed May 16, 2025.« Back to AAPM&R Annual Assembly 2022
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/does-time-to-procedure-of-epidural-steroid-injection-affect-duration-of-opioid-use-during-an-acute-episode-of-radicular-pain-from-disc-herniation/