Four-Week Outcomes of Transforaminal Epidural Injections in Patients With Lumbar Radicular Pain

Background Lumbar radicular pain occurs due to irritation or compression of the nerve roots in the lower back. This study aimed to evaluate the efficacy of transforaminal epidural steroid injections (TFESIs) in reducing pain and improving functional outcomes in a diverse patient population with lumbar radicular pain. Methodology This quasi-experimental trial was performed at the Department of Orthopedic Surgery and Traumatology, Unit 1, Mayo Hospital, Lahore, from October 2021 to September 2022. The inclusion criteria comprised patients of either gender experiencing lumbar radicular pain. The demographic and clinical profiles of all participants were recorded using a structured questionnaire. Functional status was assessed using the Oswestry Disability Index (ODI). Pain intensity was evaluated using the Visual Analog Scale (VAS). Lumbar TFESI were administered, consisting of 4 mg dexamethasone and 0.33% lidocaine in a 3 ml solution. Patients were monitored for four weeks post-treatment, and outcomes were reported in the form of pain score (VAS) and ODI score from baseline to four weeks. Secondary outcomes included the rate of return to work, patient satisfaction, and the need for additional analgesic use. Results Of the total 62 patients, 37 (59.7%) were female. The mean age was 53.34±6.84 years. The mean duration of pain was 2.31±0.95 months. Six patients lost follow-up, so those were excluded from the final analysis. The mean pain score significantly reduced from 7.0±0.85 to 1.90 ± 0.65 after four weeks of treatment (p<0.0001). There was a corresponding improvement in ODI scores from 38.5±8.7 to 20.1±5.3 (p<0.0001). Post-treatment, 38 (61.4%) patients were able to return to work within four weeks. Overall, 49 (87.5%) patients reported satisfaction with the treatment. The requirement for rescue analgesia post-injection was significantly lower, with nine (16.1%) patients needing additional pain relief measures (p<0.0001). Conclusion This study demonstrated that lumbar TFESI were effective in significantly reducing pain and improving functional outcomes after a four-week period in patients with lumbar radicular pain.