Journal of Rehabilitation Sciences & Research

Comparative Effectiveness of Caudal Epidural Steroid Injection Versus Mesotherapy of Calcitonin on Pain Reduction and Improving Function in Patients with Lumbosacral Canal Stenosis: A Randomized Control Trial

Document Type : Original Articles

Authors

Hamidreza Farpour 1, 2
Elham Sheybani 3, 4
Elahe Keshavarzi 3

1 Bone and Joint Diseases Research Center, Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran

2 Shiraz Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

3 Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran

4 Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran

https://doi.org/10.30476/jrsr.2021.90541.1149
Abstract
Background: The use of epidural steroid injection in spinal stenosis pain
management has expanded greatly. Calcitonin is also effective in relieving
neuropathic pain in spinal canal stenosis through the mechanisms of arterial
dilation, anti-inflammation, anti-edema, and rises in beta endorphin levels. The
current study was designed to evaluate the effect of mesotherapy with calcitonin
compared with epidural steroid injection for pain relief and functional
improvement in patients with lumbosacral canal stenosis.
Methods: A total of 39 patients comparable in age and gender with signs and
symptoms of lumbosacral canal stenosis participated in this randomized
control trial. Group A comprised patients receiving mesotherapy of 100 IU
Calcitonin+Marcaine 0.5% (4 mL) in three repeated injections in the lumbosacral
area; group B received a single caudal epidural injection of Marcaine 0.5%
(4 mL)+80 mg methyl prednisolone (2 mL) under the guide of a fluoroscope.
Patients were evaluated before and 4 and 8 weeks after intervention using the
visual analog scale (VAS), Oswestry Disability Index (ODI), Quebec back pain
disability scale (QBPD), and Ronald-Morris Disability Questionnaire (RMDQ).
Results: Based on the VAS, ODI, QBPD, and RMDQ scales, a significant
improvement in pain and functional disability was observed in both groups 4
and 8 weeks after intervention (P<0.05), which was comparable between the two
groups (P>0.05).
Conclusion: Mesotherapy with calcitonin Marcaine is just as effective as caudal
epidural steroid injection; considering its advantages, mesotherapy can be a
proper alternative method for managing pain and functional impairment in
patients with lumbosacral canal stenosis.

Keywords

Calcitonin
Epidural injections
Mesotherapy
Pain management
Spinal stenosis
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Journal of Rehabilitation Sciences & Research
Volume 9, Issue 1
Winter 2022
Pages 23-29

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