Background: Neuropathic pain is a major contributor to chronic low back pain and is usually treated by an epidural steroid injection (ESI).To investigate the effect of particulate and non-particulate steroid on neuropathic pain, we conducted a trial comparing a non-particulate steroid with a particulate steroid for neuropathic pain.
Methods: A total of 114 patients were enrolled. Based on the score of the pre-procedure painDETECT questionnaire (PD-Q) score, 54 patients with a PD-Q score of <12 were classified into nociceptive pain, and 60 patients with a PD-Q score ≥19 were classified into the neuropathic pain group. The patients were administered a given lumbar transforaminal ESI of either 7.5 mg dexamethasone or 40 mg triamcinolone acetate. Measurements were taken before treatment and 1 month after by a numerical rating scale (NRS) score, short form McGill Pain Questionnaire (MPQ), and revised Oswertry Back Disability Index (ODI).
Results: The differences between the NRS, MPQ, and ODI of the nociceptive pain and the neuropathic pain groups before and after treatment were not significant. The triamicinolone and dexamethasone did not show significantly on the NRS, MPQ, or ODI either before and after treatment.
Conclusion: For the short-term relief of neuropathic pain, an epidural injection of triamcinolone was not more effective than dexamethasone. Therefore, dexamethasone is also a useful drug for patients with neuropathic pain.