Exercise Therapy After Caudal Epidural Steroid Injection

Launched by ÇANKIRI KARATEKIN UNIVERSITY · May 1, 2025

Keywords

ClinConnect Summary

This clinical trial is exploring the benefits of two different types of exercise programs for people who have received a caudal epidural steroid injection (CESI) for back pain caused by a herniated disc. The trial aims to find out if adding moderate aerobic exercise or core-stabilization exercises to standard physiotherapy can help reduce pain and improve daily functioning better than physiotherapy alone. Participants will take part in a six-week program, starting two weeks after their injection, where they will be randomly assigned to one of three groups: conventional physiotherapy only, physiotherapy plus aerobic exercise, or physiotherapy plus core-stabilization exercises.

To be eligible for the study, participants should be adults aged 18 to 70 who have had an MRI confirming a herniated disc and have experienced ongoing pain after their CESI. They must also be cleared by their doctor to take part in moderate exercise and be able to attend physiotherapy sessions three times a week. Throughout the trial, participants will complete questionnaires and receive support from physiotherapists, with follow-ups to see how their pain and quality of life change over time. This study could help shape better recovery plans for individuals dealing with similar back issues in the future.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Age 18 to 70 years.
• • MRI-confirmed lumbar intervertebral disc herniation.
• • Has received a caudal epidural steroid injection (CESI) within the past 2 weeks at Çankırı State Hospital.
• • Low-back or leg pain intensity ≥ 3 cm on a 10-cm Visual Analogue Scale after the injection.
• • Medically cleared for moderate aerobic and core-stabilisation exercise (no cardiac or orthopaedic contraindications).
• • Able to attend supervised physiotherapy three times per week for six weeks.
• • Willing and able to give written informed consent and to comply with study procedures.
• • Sufficient Turkish literacy (minimum primary-school education) to complete questionnaires.
• Exclusion Criteria:
• • Uncontrolled systemic disease (e.g., poorly controlled diabetes mellitus, congestive heart failure, active hepatitis C or other significant liver disease).
• • Neurological red flags such as myelopathy or cauda equina syndrome.
• • Previous lumbar spine surgery at the affected disc level.
• • Current pregnancy or planning pregnancy during the study period.
• • Severe musculoskeletal, cardiovascular, or respiratory condition that precludes safe exercise participation.
• • Use of systemic corticosteroids or opioid analgesics that cannot be stabilised for the duration of the trial.
• • Ongoing litigation or workers' compensation claim related to low-back pain.
• • Inability to communicate effectively with study staff or to follow instructions.