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Pain and Spine Medicine

Session: Short- and long-term outcomes following epidural steroid injections and exercise-based physical therapy in patients with lumbar radiculopathy

Short- and Long-Term Outcomes Following Epidural Steroid Injections and Exercise-Based Physical Therapy in Patients with Lumbar Radiculopathy

Friday, October 24, 2025
8:00 AM - 9:15 AM MT
Location: Kiosk 9
Disclosure(s):
Stephen Massimi, MD: No financial relationships to disclose
Peter Moley, MD: No financial relationships to disclose
Background and/or Objectives: Exercise-based physical therapy (PT) and epidural steroid injections (ESIs) are often used to manage lumbar radiculopathy; however, few studies support the efficacy of ESIs in long-term pain relief. Additionally, research on the combined use of PT and ESIs is limited. The purpose of this study was to evaluate the clinical outcomes of patients with lumbar radiculopathy who underwent an ESI alongside exercise-based PT.

Design: Prospective repository study

Setting : Outpatient spine/musculoskeletal clinic

Participants : 105 repository patients who were diagnosed with lumbar radiculopathy, received an initial ESI, underwent exercise-based PT, and had available follow-up data.

Interventions: ESI and exercise-based PT

Main Outcome Measures: Patient-reported outcomes PROMIS Global Health-10 (physical and mental health components), PROMIS Physical Function-Computer Adaptive Test, and current and average numerical rating scale (NRS) pain, completed at baseline, 2 weeks, 3 months, and 1-year post-procedure.

Results: The mean age was 55.8±16.9 years, and 51% (n=54) of patients were male. Most patients (83%, n=87) received PT prior to an ESI, whereas 93% (n=92 of 99 with available) of patients underwent PT following their injection. Of the 105 patients, 79 (75%) achieved successful outcomes, as defined by meeting the minimal clinically important difference (MCID) criteria for pain or function. Current and average NRS pain scores were significantly decreased at the post-injection timepoints (p < 0.001). Additionally, PROMIS physical function and PROMIS-Physical Health component scores were significantly improved at all follow-up timepoints (p≤0.007).

Conclusions: ESIs, alongside exercise-based PT, were associated with significant improvements in pain and functional outcomes in patients with lumbar radiculopathy, meeting the MCID criteria at 1-year post-procedure. Such findings suggest a need for future higher-powered investigation of the combined use of ESIs and exercise-based PT to manage lumbar radiculopathy.