[Efficacy of epidural XXXX injections for chronic @entity158 syndromes without @entity51 : A randomized, double blind study as part of a multimodal treatment concept].

@entity1 @entity32 @entity2713 @entity121 @entity51 @entity1341 @entity158 @entity230 @entity1118 @entity479
BACKGROUND: @entity1118 syndromes without @entity51 are generated by a multitude of causes. Functional, morphological and psychosocial factors are discussed. In many cases a diseased intervertebral disc is found on radiological examination but the clinical relevance of these findings is not clear. For this study it was postulated that a diseased disc results in a local inflammatory reaction therefore causing @entity158 and impairing treatability of @entity1 . An epidural injection of @entity230 can reduce @entity32 and therefore improve treatability and ultimately treatment outcome. METHODS: A double blind randomized prospective trial was carried out. @entity1 treated in hospital for a chronic @entity158 without @entity51 within a multimodal treatment program were screened for indications for an epidural @entity479 injection (e.g. diseased lumbar disc and intention to treat). @entity1 eligible for the study were randomized into two groups. The treatment group received an epidural injection of 80  mg @entity2713 and 8  ml @entity1341 0.25   %. The control group received only an epidural injection of 8  ml @entity1341 0.25   %. RESULTS: In both groups @entity158 intensity and treatability showed a statistically significant improvement after the epidural injection. The differences between the control and treatment groups were small and not clinically relevant. A small subgroup might profit from the @entity479 injection. In addition the treatability was dependent on psychometric values and the long-term outcome from a @entity121 . DISCUSSION: After the epidural injection the decrease in @entity158 and increase in treatability was statistically significant. The mechanism of the improvement is not clear and should be examined further. The epidural injection of a @entity479 in this subgroup of @entity1 did not lead to a clinical improvement in the outcome.
