Analgesic effects of trigger point injection combined withcaudal epidural steroid injection

Chronic back pain, which has many different etiologies, is getting more and more common. Today, myofascial back pain that stems form vertebral structures stands out among them. Many methods have been tried in the course of treatment for these afflictions. While steroids are usually the choice of treatment for discogenic pain, trigger point injections are used for myofascial back pain. Taking into account the fact that both etiologies could play a role in back pain we coupled trigger point injections with caudal injections. We aimed to observe patients' pain, limitations and quality of life under this multimodal therapy method. This prospective, randomized study was carried out in Bolu Abant İzzet Baysal Training and Research Hospital. 72 patients aged between 18 and 75 with chronic back or hip pain were included. They were randomly divided into two groups; group C (caudal steroid injection group, n:36) and group CT (caudal steroid + trigger point injection group, n:36). Numerical Rating Scale-NRS scores were used as the primary output for our study. In addition; to evaluate disability and quality of life, Oswestry Disability Index (ODI) and Short Form-36 (SF-36) scales were ısed respectively. Patients were examined before and 3, 6 and 12 weeks after injection. Patients who had an NRS score of 4 or higher at the third and sixth week exam were treated again. In both groups, compared with previous values, a decrease in NRS and ODI scores and a significant improvement in SF-36 scale was observed. Group CT had a statistically significant decrease in NRS and ODI score at all times (p<0,05). In SF-36 scale, group CT had an improved scoring in physical function, physical role, social function, mental health and pain which was found to be statistically significant. As a result we observed that the analgesic effect of trigger point injection coupled with caudal steroid injection was stronger than just caudal steroid injection. Furthermore we witnessed an upturn in their quality of life and degree of disability.