Lumbar infiltration with local anesthetics and corticosteroid in the treatment of chronic low back pain: a retrospective study of 80 cases
Abstract
Case Presentation: Chronic low back pain is a major cause of functional disability, commonly associated with conditions such as myofascial syndrome, facet arthropathy, disc protrusions, and L4–S1 radiculopathies. This retrospective study, conducted in 2025 at a tertiary hospital, evaluated 80 patients aged 35–60 years with chronic low back pain (>6 months) refractory to clinical treatment. At admission, the mean Visual Analog Scale (VAS) score was 7, with a peak of 10, associated with clinical signs of lumbosacral involvement (positive straight leg raise test, radiating pain, paresthesia, and reflex changes). All patients had failed prior pharmacological and physical therapy treatments. Patients underwent lumbar infiltration with dexamethasone (10 mg), bupivacaine (4 mg/kg), and lidocaine (3 mg/kg), without vasoconstrictor. Pain was assessed at multiple time points up to 12 months. Discussion: Initial improvement was observed in 100% of cases, with a reduction in VAS to a mean of 4 at 60 days. The analgesic effect lasted up to 4 months, followed by progressive worsening in patients receiving a single injection, with return to baseline pain levels (VAS 7) at 1 year. In contrast, 25% of patients who underwent repeated quarterly injections maintained a mean VAS of 3, with sustained functional improvement and no return to baseline pain. No adverse events or complications were reported. These findings suggest that lumbar infiltration is effective but has a time-limited effect. Scheduled repeated injections demonstrated superior sustained pain control. The unavailability of thermal rhizotomy may have limited longer-lasting outcomes. Final Comments: Lumbar infiltration with local anesthetics and corticosteroid is a safe and effective option for short-term relief of chronic low back pain, lasting up to 4 months. Quarterly repetition of the procedure appears necessary to maintain clinical benefit, improving long-term pain control and function over a 1-year follow-up.