The impact of epidural steroid injections on pain, function, and psychological outcomes in patients with chronic radicular pain: a prospective cohort study Epidural steroids in radicular pain

Aim: Low back pain with radiculopathy due to lumbar disc herniation is a major cause of disability. The outcomes of epidural steroid injections (ESIs), which are commonly performed when conservative therapies fail, are variable, and the effects of psychological factors, including pain catastrophizing, depression, and anxiety, on these outcomes remain underexplored. In this context, the objective of this study is to evaluate the effects of ESIs on pain severity, functional status, and psychological parameters, and to investigate the correlations between pain reduction and psychosocial outcomes over time. Material and Methods: The sample of this prospective observational cohort study consisted of 50 patients with chronic radicular pain due to lumbar disc herniation who underwent ESIs and were followed up for three months. Patients’ pain intensity, functional disability, psychological status, pain catastrophizing status, and quality of life were assessed at three time points, i.e., baseline, after one month, and after three months, using numeric rating scale (NRS), Oswestry disability index (ODI), hospital anxiety and depression scale (HADS), pain catastrophizing scale (PCS), and brief pain inventory (BPI), including BPI relations with others, enjoyment of life, and mood (BPI REM) and BPI walking, activity, and work (BPI WAW) subscales, respectively. Changes in outcomes were analyzed using non-parametric tests, and correlations were evaluated using Spearman’s rho and heatmap analyses. Results: ESIs led to significant improvements in all parameters. Patients’ median NRS score decreased from 8.0 at baseline to 2.0 at both one and three months after they underwent ESI (p