Abstract
Purposes: To assess the influence of patients’ positioning following caudal epidural injections on the outcome.
Methods and Results: 58 patients with low back pain and sciatica undergoing caudal epidural injection were prospectively and randomly allocated into 2 groups. 28 patients (Group 1) were positioned on the side (same side of sciatica) following the injection while 29 patients (group 2) were laid on the back. Patients were assessed using Oswestry disability index and the leg pain intensity was scored using Numerical pain intensity scale before surgery and after 6 weeks following the procedure. Pre-and postoperative pain scores were reviewed for each individual patient and the rate of improvement or worsening was noted. In group 1, 92.8 % of patients had their leg pain improved and 7.2 % remained unchanged. In group 2 however, 77% of patients did improve whereas 13.7% failed to do so and 6.8 deteriorated on the pain scale. There was a statistically significant difference in the degree of pain score improvement in favour of Group1 (Mean: 2.75 points on the scale for group 1 versus mean: 1.31 for group 2, P< 0.001, Mann-Whitney test). No difference was noted between the two groups in the improvement in the disability index (P< 0.14).
Conclusions: Lying on the symptomatic side following caudal epidural injection has improved the result in terms of pain control. Such a simple manoeuvre could add benefit to the injection in terms of pain for which the procedure is mainly indicated. The longstanding functional disability remained unchanged.
Ethics approval: None
Interest Statement: None
Correspondence should be addressed to BASS/BCSS c/o BOA, at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE, England.
