Comparison of Radiofrequency Thermocoagulation Alone with Radiofrequency Thermocoagulation and Steroid Injection in Combination for the Treatment of Lower Back Pain

Abstract

Objective: Lower back pain is the most common disease of the musculoskeletal system. Analgesics, myorelaxant drugs, bed rest, physical therapy, and conventional treatments are first-line treatments for lower back pain. In addition, conventional radiofrequency thermocoagulation (RFT) and caudal steroid injection (CSI) are common conventional therapies. The present study aims to compare the results of RFT alone with combination therapy using RFT and CSI. The effectiveness of these treatment methods in patients with chronic lower back pain is evaluated. Method: A total of 62 patients with lower back pain who underwent epidural CSI and RFT in neurosurgery clinic between January 2018 and May 2019 were included. Results: Of the 62 patients included in the study, RFT+CSI was performed in 30 patients (48.3%). A visual analog scale (VAS) scores before and after the procedure; a statistically significant difference was only observed between the RFT+CSI and RFT group scores (p=0.030) in the sixth month after the procedure, and it was observed that the pain decreased more in the RFT+CSI group. Conclusion: The present study considered body mass index (BMI), occupation, gender, age, and procedure levels. We conclude that both RFT and RFT+CSI are effective treatment methods for chronic lower back pain that does not improve after conservative or physical therapy. BMI has a direct effect on lower back pain. The VAS score decreased significantly in patients who underwent both the RFT and RFT+CSI procedures, and RFT+CSI appeared more effective in terms of the 6-month VAS score.