Epidural corticosteroid injection and amitriptyline for the treatment of chronic low back pain associated with radiculopathy

OpenAlex İngilizce

The therapeutic role of epidural steroids has not been established for patients whose chances for improvement are poor, e.g. patients with chronic symptoms. In such cases, supplementary treatment with some medications are proposed, but no randomised prospective study is available regarding the results of these combinations. In this study, we evaluated the outcome of a protocol consisting of amitriptyline and epidural corticosteroid. Ninety-two patients suffering from chronic low back pain together with unilateral radicular involvement were introduced into the study. The patients were randomly assigned to two groups. All patients received benzylprednisolone (14 mg) + bupivacaine (0.25%) combination via epidural route. In addition, amitriptyline (10–50 mg p.o.) was administered to group 2 for 9 months. The results were assessed by a visual analogue scale and Oswestry Low back Pain Disability Questionnaire. At 2 weeks, both groups showed statistically significant improvement. At 6 weeks, recovery was earlier in group 2 and fewer repeat injections were necessary. At 9 months, group 1 did not statistically differ from the baseline values, while group 2 had sustained improvement. The study showed that epidural steroid and amitriptyline combination proved beneficial in the management of chronic low back pain associated with radiculopathy.