Clinical Efficacy of Methylprednisolone Acetate Versus Dexamethasone for Transforaminal Epidural Steroid Injection in Chronic Low Back Pain: A Prospective Comparative Study

Background: Transforaminal epidural steroid injection is used for radicular pain associated with lumbar disc pathology.This study compared methylprednisolone acetate and dexamethasone for pain relief following transforaminal epiduralsteroid injection. Materials and Methods: This prospective comparative randomized study included 80 patients withherniated intervertebral disc, divided into Group M receiving methylprednisolone acetate 40 mg and Group D receivingdexamethasone 8 mg. NRS scores were recorded at baseline, Day 1, 2 weeks, 6 weeks and 12 weeks. Adverse effects werealso recorded. Results: Baseline NRS scores were comparable between Group M and Group D (8.8 ± 0.6 vs 8.6 ± 0.9;p=0.24). Day-1 scores were also similar (2.9 ± 1.0 vs 2.8 ± 1.2; p=0.68). NRS scores were lower with methylprednisolone at2 weeks (2.8 ± 1.2 vs 3.6 ± 1.4; p=0.007), 6 weeks (3.2 ± 1.4 vs 4.8 ± 1.3; p<0.0001) and 12 weeks (5.1 ± 1.6 vs 6.1 ± 1.2;p=0.002). Most patients had no adverse effects in either group. Conclusion: Both steroids provided marked early pain relieffollowing transforaminal epidural injection. Methylprednisolone showed better sustained pain reduction from 2 to 12 weekscompared with dexamethasone. Adverse effects were infrequent in both groups.