Effect of body mass index in patients administered epidural steroid injection for back pain

Abstract

Aim: The aim is to investigate the efficacy of epidural steroid injection applied for lumbar discopathy pain to obese and non-obese patients with continuing complaints of back pain, despite the application of medical treatment and physical therapy. Material and Method: The study included 119 patients aged 31-73 years who presented at the Algology Clinic with complaints of back and leg pain which had been ongoing for at least 6 months and with single level disc pathologies, and for whom epidural steroid injection was planned. The patients were separated into 2 groups as obese (BMI ≥ 30kg/ m2) and non-obese (BMI<30kg/m2); 48 patients were evaluated as obese and 71 as non-obese. Pain palliation in obese and non-obese patient groups was compared using early stage and 1st year VAS scores and the functional status was evaluated with the Oswestry Scale. Results: In all patients there was found to be a statistically significant fall in the VAS and Oswestry values at 30 days, 6 months, and 12 months after the first ESI compared to the pre-treatment values (p<0.0001). A second injection was applied to 56 patients with VAS ≥ 5. There was no statistical difference between obese and non-obese patients who were administered a second injection (p=0.597). There was a significant palliation of pain and functional improvement in both obese and non-obese patient groups following the second injection, with no statistically significant difference between the groups. Discussion: In patients with single level lumbar discopathy, where sufficient palliation of pain and functional improvement has not been achieved despite the application of analgesia and physical therapy, the application of ESI can be considered an effective treatment method for both obese and non-obese patients.