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After one month,none of the outcome measures evaluating pain,functional status,and back flexion differed clinically or statistically between the two study groups.Forty-two percent of the patients who received methylprednisolone and 33 percent of those who received placebo reported marked or very marked improvement(95 percent confidence interval for the difference,-11 to 28 percentage points;P=0.53).The results were similar after three months.At the six-month evaluation,the patients treated with methylprednisolone reported more improvement,less pain on the visual- analogue scale,and less physical disability.The differences were reduced, however,when concurrent interventions were taken into account.Moreover, only 11 patients(22 percent)in the methylprednisolone group and 5(10 percent)in the placebo group had sustained improvement from the first month to the sixth month(95 percent confidence interval for the difference,-2 to 26;P=0.19).We conclude that injecting methylprednisolone acetate into the facet joints is of little value in the treatment of patients with chronic low back pain. |
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