Comparative Effectiveness Study of Pulsed Radiofrequency Versus Caudal Epidural Steroid Injection for the Treatment of Lumbar Back Pain And Radicular Pain Due to Disc Herniation and Sciatica

Background: Pain or discomfort in the lower back, particularly the lumbar spine, is known as lumbar back pain.

Objective: The aim of this study was to conduct a comparative trial of pulsed radiofrequency treatment versus caudal epidural steroids for the treatment of lumbar back pain and radicular pain due to herniated disc and sciatica.

Patients and methods: We conducted a comparative study of patients undergoing treatment for radicular pain due to disc herniation, which included 60 samples whose ages ranged between 45 and 65 years. All patient data were collected from hospitals in Baghdad and Erbil, Iraq, over a one-year period between August 2023 and August 2024. The patients were divided into two groups; the first group included 30 patients who underwent pulsed radiofrequency (PRF) treatment, and the second group included 30 patients who underwent caudal epidural steroid injection, with the percentage of males being 40% and females 60%. To evaluate the functional aspect after the treatments, all patients had undergone VAS and NRS scales to assess radicular and lumbar pain and functional disability. A questionnaire was used to assess patients' quality of life after treatment.

Results: A total of 60 patients were included in this study. We found patients with age (≥ 50) years had 70% of total patients, males were 40% cases and females were 60%, patients with lumbar back pain got 38 cases and, patients with radicular pain got 22 cases, and most cause prevalent in the patients had 23.33% of patients with pulsed radiofrequency treatment, while 30% of patients had caudal epidural steroid injection treatment. In terms of VAS pain assessment, we found patients with pulsed radiofrequency was 2.1 ± 0.7, while patients with caudal epidural steroid injection was 2.5 ± 2.2 after 2 months. In terms of ODI in disability function, we found that in patients with pulsed radiofrequency, it was 3.5 ± 1.0, while in patients with caudal epidural steroid injection, it was 2.3 ± 0.8 after 2 months.

Conclusions: The results show that both treatments showed positive efficacy in significantly reducing radicular pain due to disc herniation and sciatica.