EPIDURAL STEROID INJECTION FOR LUMBAR DISC HERNIATION IN NFL ATHLETES

Review written by Dr Fiona Wilson info

BACKGROUND & OBJECTIVE

Low back pain (LBP), specifically disc herniations, is very common in sports such as football. Managing LBP is challenging in high level athletes where early return to sport (RTS) is the primary goal. Conservative treatment of disc herniations is reported as 79% with RTS at a mean of 4.7 months. There is limited research supporting the use of epidural steroid injections in athlete LBP as a result of disc herniation. The aim of this study was to demonstrate the efficacy of epidural steroid injections in RTS after lumbar disc herniation, and to recognise risk factors for failure of this treatment approach.

METHODS

Retrospective review of medical records of a professional football club from 2003-2010 was conducted. To be included, the player had to sustain a back injury during playing or training resulting in a herniated nucleus pulposus confirmed on MRI. Initial management for players included rest, ice and removal of aggravating activities. All players included in the study had an injection of triamcinolone and anaesthetic and rested for 48 hours. RTS was measured from time of sustaining the injury.

RESULTS

Seventeen male players had a total of 37 injections for 27 lumbar disc herniation episodes from 2003 to 2010. Mean age was 25yrs (range = 22-32yrs). MRI showed that 15 of the disc herniation episodes occurred at the L4-5 level,

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