This prospective randomized study will be conducted in Bolu Abant İzzet Baysal University Hospital. Chronic low back and hip pain 72 patients aged between 18-70 years will be included in the study. The primary output of our study was NRS scores. The study of Manchikanti. L et al. (control group NRS reduction 4.4 ± 1.8; α margin of error 0.05, power 99%) (3) was taken as the basis for determining the sample size. Using the G Power 3 calculator program, 72 patients were identified to reduce their NRS scores by 25%. With a 20% exclusion rate, the total number of patients was calculated as 90
Demographic information of all patients included in the study; name, surname, telephone number, age, gender, educational status, profession, and marital status will be recorded. The duration of the pain, the onset of the pain, the accompanying leg pain, the activities that increase or decrease the pain, the presence of neurological symptoms, the analgesic agents used in the last week, and the previous treatments will be noted. Lumbar MRI findings and the level of pathology causing low back and hip pain will be recorded. History, family history, comorbidities (hypertension, diabetes mellitus, hyperlipidemia, cardiac disease, hypothyroidism), and detailed physical examinations of the patients will be recorded. Examinations of the patients before and 3, 6, and 12 weeks after the injection will be performed, and NRS scores at 3 and 6 weeks. The procedures will be repeated for patients who are over 4 years old. During the pre-procedural evaluation, the patients will be informed about the study, information about the Numeric Rating Score (NRS), Oswestry Disability Index (ODI), Short Form-36 (SF-36) to be used for post-procedure analgesia, and both verbal and written consents will be obtained. The staff who will make the evaluation will not know which group the patients belong to, and the study will be blinded.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
trigger point injection will be added to the gluteus medius and minimus muscles in addition to caudal epidural steroid injection.
It will be advanced towards the sacral hiatus and local anesthesia of the skin and subcutaneous tissue will be provided with 2% lidocaine. The caudal epidural space will be entered by puncturing the sacrococcygeal ligament with the tip of a 22 G black needle from the appropriate area and taking a pop sensation. It will be confirmed that there is no bleeding or cerebrospinal fluid in this area by applying saline in real-time sonography and after the caudal epidural spread is observed, aspiration is performed. Afterward, a 10 mL volume of bupivacaine 4cc/20mg+ triamcinolone 2cc/80mg+0.09% NaCl 4cc mixture will be administered into the caudal epidural space
Abant Izzet Baysal University Medical School,
Bolu, Turkey (Türkiye)
RECRUITINGNumerical Rating Scale (NRS) score
NRS score measures a patient's pain intensity. For example, (range 0-10) where 0 is no pain and 10 is the worst pain
Time frame: basaline,
Numerical Rating Scale (NRS) score
NRS score measures a patient's pain intensity. For example, (range 0-10) where 0 is no pain and 10 is the worst pain
Time frame: after ESİ 3 weeks,
Numerical Rating Scale (NRS) score
NRS score measures a patient's pain intensity. For example, (range 0-10) where 0 is no pain and 10 is the worst pain
Time frame: after ESİ 6 weeks
Numerical Rating Scale (NRS) score
NRS score measures a patient's pain intensity. For example, (range 0-10) where 0 is no pain and 10 is the worst pain
Time frame: after ESİ12 weeks
Oswestry Disability Index
used to qualify low back pain.(range 0 to 100).Zero is equated with no disability and 100 is the maximum disability possible
Time frame: basaline
Oswestry Disability Index
used to qualify low back pain.(range 0 to 100).Zero is equated with no disability and 100 is the maximum disability possible
Time frame: after ESİ 3 weeks
Oswestry Disability Index
used to qualify low back pain.(range 0 to 100).Zero is equated with no disability and 100 is the maximum disability possible
Time frame: after ESİ 6 weeks
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72
Oswestry Disability Index
used to qualify low back pain.(range 0 to 100).Zero is equated with no disability and 100 is the maximum disability possible
Time frame: after ESİ12 weeks
Short Form-36
used to measure of patient's health status.The SF-36 consists of eight scaled scores, which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The lower the score the more disability. The higher the score the less disability i.e., a score of zero is equivalent to maximum disability and a score of 100 is equivalent to no disability.
Time frame: basaline
Short Form-36
used to measure of patient's health status.The SF-36 consists of eight scaled scores, which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The lower the score the more disability. The higher the score the less disability i.e., a score of zero is equivalent to maximum disability and a score of 100 is equivalent to no disability.
Time frame: after ESİ 3 weeks,
Short Form-36
used to measure of patient's health status.The SF-36 consists of eight scaled scores, which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The lower the score the more disability. The higher the score the less disability i.e., a score of zero is equivalent to maximum disability and a score of 100 is equivalent to no disability.
Time frame: ,after ESİ 6 weeks
Short Form-36
used to measure of patient's health status.The SF-36 consists of eight scaled scores, which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The lower the score the more disability. The higher the score the less disability i.e., a score of zero is equivalent to maximum disability and a score of 100 is equivalent to no disability.
Time frame: after ESİ12 weeks