Randomized Controlled Trial Comparing the Efficacy and Safety of Epidural Infiltration of Particulate Versus Nonparticulate Steroids in the Treatment of Patients with Sciatic Pain

Epidural corticosteroid injections are widely used to treat low back pain, but doubts exist about the relative efficacy of particulate versus non-particulate corticosteroids. Epidural corticosteroid injections were performed in 75 patients with chronic radicular pain were evaluated for epidural corticosteroid injections to determine if there was a difference in the efficacy of triamcilone acetate, methylprednisolone acetate, and dexamethasone. Methods: 75 patients presenting with debilitating radicular pain were randomized to receive an injection of triamcilone acetate 40 mg/ml, methylprednisolone acetate 40 mg/ml, and dexamethasone phosphate 7.5 mg/ml at equal doses. Data were collected at 1-month and 3-month follow-up. The primary outcome of the present study was reduction in pain on a visual analog scale (VAS) at 3 months, while the secondary outcome was the type and number of complications in the study group. Results: Regardless of baseline score VAS, pain score decreased in all patients at one and three months. The patients with VAS of very severe also showed a statistically significant success rate at one and three month follow-up [p= 0.043]. No serious complications occurred in all three groups. Conclusion: According to this study, pain relief and functional improvement are similar among all three methylprednisolone acetate, triamcilone acetate and dexamethasone phosphate at 3 months.