الفهرس | Only 14 pages are availabe for public view |
Abstract Low back pain (LBP) is a common problem and a signifi¬cant cause of morbidity and socioeconomic loss to society. Lumbar radicular pain syndrome is a constellation of symptoms includ¬ing neurogenic back and lower extremity pain emanating from the lumbar nerve roots. Radicular pain syndrome result from both mechanical and chemical irritation of the nerve roots with resulting inflammation, oedema and swelling of these nerves. Conservative treatment of patients with lumbar radicular pain syndrome includes bed rest, analgesic medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen, muscle relaxants, oral or parenteral steroids, and opioids as well as therapeutic exercises. Epidural steroid injections (ESIs) are an established method of pain management in lumbar radicular pain syndrome. In fact, ESIs are the most widely performed pain management procedure in the world. Steroids work by inhibiting the arachidonic acid cascade thereby limiting inflammation of the lumbar nerve roots. Recent evidence also has demonstrated effectiveness for fluoroscopically administered epidural injections in the cervical spine as well as the thoracic spine. The use of platelet-rich plasma (PRP), which is plasma containing concentrated platelets obtained from autologous blood, is one of the new biological therapies being researched for use in LBP. Proponents of PRP refer to it as a bridge between conservative therapy and surgery. |