Corticosteroid Injection Treatment to the IschiadicSpine Reduced Pain in Women With Long-LastingSacral Low Back Pain With Onset During Pregnancy: A Randomized, Double Blind, Controlled Trial

• Published in: Spine (Philadelphia, Pa. 1976) Pa. 1976), 2009, Vol.34 (21), p.2254
• Main Authors: Torstensson, Thomas, Lindgren, Anne, Kristiansson, Per
• Format: Article
• Language: English
• Subjects: corticosteroid; injections; low back pain; pelvic pain; Physiotherapy; Pregnancy; Sjukgymnastik/fysioterapi
• ISSN: 0362-2436; 1528-1159
• DOI: 10.1097/BRS.0b013e3181b07eac

Study Design Randomized double blind controlled clinical trial.Objective. To evaluate the pain relief effect of locally injected corticosteroid treatment in women with long-lasting sacral low back pain with onset during pregnancy. Summary of Background Data Pregnancy-related low back pain is a global problem. Almost 1 of 10 women still experienced disabling daily back pain 2 years after childbirth with high impact on the individual, family, and society. In spite of this, the sources of pain and effective treatment are uncertain. Methods Thirty-six women were allocated to injectiontreatment, with slow-release triamcinolone and lidocaine or saline and lidocaine, given at the sacrospinous ligament insertion on the ischial spine bilaterally with 4 weeks follow-up time. Primary outcome measure was reported pain intensity on visual analogue scale and secondary outcome measures number of pain-drawing locations and pain-provoking test results.' Results The triamcinolone treatment group had significantly reduced pain intensity, number of pain locations,and pain-provoking test results between baseline and follow-up as compared with the saline treatment group. The absolute median change of visual analogue scale score in the triamcinolone treatment group was 24 mm and in the saline group 4.5 mm (P‹0.05). A reducednumber of pain drawing locations was reported by16 of 18 women in the triamcinolone group as compared with 10 of 18 in the saline group (P‹0.05). In the triamcinolone treatment group, 17 of 18 women had an improved pain provocation test result as compared with 9 of 18 in the saline treatment group (P‹0.01). Conclusion The anatomic region around the sacrospinousligament insertion on the ischial spine is suggestedto be one source of long-lasting sacral low back pain withonset during pregnancy. The pain was relieved by slowrelease corticosteroid injection treatment to the ischial spine.