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Effectiveness of Caudal Epidural Injections in Treatment of Chronic Low Back and Lower Extremity Pain

Early Phase 1
Completed
Conditions
Low Back Pain
Interventions
Drug: Caudal epidural injection
Drug: Caudal Epidural Injection with generic Celestone
Drug: Caudal Epidural Injection with Celestone
Drug: Caudal Epidural Injection with DepoMedrol
Registration Number
NCT00370799
Lead Sponsor
Pain Management Center of Paducah
Brief Summary

To demonstrate clinically significant improvements or lack thereof in the caudal epidural patients with our without steroids.

To evaluate differences in outcomes in patients receiving steroids compared to those patients randomized to the local anesthetic group who did not receive steroids.

To assess improvements among patients and compare steroid groups with each other and local anesthetic group.

To evaluate and compare the adverse event profile in all patients

Detailed Description

Patients with chronic low back pain of at least 6 months duration, non-responsive to conservative management with NSAIDS, physical therapy or chiropractic treatment exercises.

A single-center, prospective, controlled, double blinded, randomized study of patients in 4 groups.

* Group 1. local anesthetics only

* Group 2. local anesthetic with 6mg of non-particulate Celestone

* Group 3. local anesthetic with 6 mg of brand name Celestone

* Group 4. local anesthetic with 40 mg of alcohol-free DepoMedrol

All patients will be unblinded in 12 months.

Non-responsive patients will be unblinded after 3 months and will be crossed over to a different group

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
240
Inclusion Criteria
  • At least 18 years of age
  • History of chronic, function-limiting low back pain of at least 6 months duration
  • Able to give voluntary, written informed consent to participate,
  • Able to understand the investigation, cooperate with the procedures, and willing to return for follow-up
  • No recent surgical procedures within last three months
Exclusion Criteria
  • Cauda Equina symptoms and/or compressive radiculopathy
  • Narcotic use of no greater than 100mg/day hydrocodone, 60mg Methadone. or 100mg morphine
  • Uncontrolled major Depression or uncontrolled psychiatric disorder
  • Uncontrolled or acute medical illnesses
  • Chronic severe conditions that could interfere with outcome assessments
  • Women who are pregnant or lactating
  • Subjects who have participated in a clinical study with an investigational product within 30 days of enrollment
  • Patients with multiple complaints involving concomitant hip osteoarthritis
  • Inability to achieve proper positioning and inability to understand informed consent and protocol
  • History of adverse reaction to local anesthetic or anti-inflammatory drugs and history of gastrointestinal bleeding or ulcers

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
local anestheticCaudal epidural injectionGroup 1. local anesthetics only
Local anesthetic with generic CelestoneCaudal Epidural Injection with generic CelestoneGroup 2. local anesthetic with 6mg of non-particulate Celestone
Local anesthetic with CelestoneCaudal Epidural Injection with CelestoneGroup 3. local anesthetic with 6 mg of brand nameCelestone
Local anesthetic with DepoMedrolCaudal Epidural Injection with DepoMedrolGroup 4. local anesthetic with 40 mg of alcohol-free DepoMedrol
Primary Outcome Measures
NameTimeMethod
To evaluate for differences between the patients in various groups in the physical function and pain at 1, 3, 6, and 12 months post treatment1,3,6,12 months
Secondary Outcome Measures
NameTimeMethod
To assess adverse events in all four groups.1,3,6,12 months

Trial Locations

Locations (1)

Ambulatory Surgery Center

🇺🇸

Paducah, Kentucky, United States

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