Comparison of epidural steroid injection with physical therapy in chronic neck pain

AIM: Although neck pain usually has a good prognosis, chronicity and recurrence rates are high. Pain becomes chronic in 30% of patients and lasts longer than 6 months in 14%. This emphasizes the importance of accurate assessment of neck pain and effective management strategies. Early treatment can prevent chronicity and reduce treatment costs. We aimed to retrospectively evaluate physical therapy modalities compared with epidural steroid injection (ESI) in terms of pain, function and disability indices. MATERIALS AND METHODS: Sixty-six patients who presented to the Physical Medicine and Rehabilitation and Algology outpatient clinics of Sakarya University Training and Research Hospital with chronic (more than 3 months) neck pain and were diagnosed with cervical spondylosis by conventional radiography and MRI were evaluated with routine treatments. These patients received physical therapy (PT) (hot pack, TENS and US) and cervical stabilization exercises or cervical stabilization exercises with cervical ESE and were followed up for 6 months (pre-treatment, 1st month, 3rd month and 6th month) with NRS, SF-12 and neck disability index. RESULTS: Significant improvements were observed in NRS, NDI, PCS and MCS values in the FT and ESE groups after treatment. In the epidural steroid injection group, the treatment effect was stronger in the first month (t1), while the physical therapy group maintained well-being longer in the long term (t1-t3). Demographic characteristics (gender, comorbidity) made a difference in response to treatment in some measures. CONCLUSION: The comparison of physical therapy and algological treatment modalities in chronic neck pain reveals the importance of individualized treatment programs. The results showed that while rapid improvement was observed in the early period in the ESE group, the well-being achieved in the FT group could be sustained in the longer term. This provides an important basis for the development of approaches that will increase adherence to treatment and provide realistic goals.