Efficacy of epidural verapamil injection for chronic lumbar radicular pain: A randomized, double blind study.

Efficacy of epidural verapamil injection for chronic lumbar radicular pain: A randomized, double blind study.

Lumbar radiculopathy is a common source of chronic low back and leg pain Pain processing involves calcium channels found on dorsal horn and causes release of substance P, glutamate resulting in nociception. Verapamil is a calcium channel blocker and has been used via neuraxial route to potentiate the effects of local anesthetic/opioids for peri operative analgesia. The aim of the study was to compare verapamil as an adjuvant to epidural steroid in patients with radiculopathy due to lumbar disc herniation

This randomized controlled trial was conducted in 71 patients with unilateral lumbar radicular pain undergoing epidural injections. Patients were randomized into 2 groups – Group C (Epidural injection – 80 mg triamcinolone) and Group V (Epidural injection of 80 mg triamcinolone + 5 mg verapamil). Patients were followed for 6 months. The outcomes were comparison of numerical rating scale (NRS) for pain, Oswestry disability index (ODI) scores and successful outcome at follow up between the two groups

The NRS and ODI scores are shown in Table 1 and were not statistically significant between the groups. Successful outcome was defined as > 50% reduction in NRS and 10 point decrease in ODI. Successful outcome was better in verapamil group at 3 months. No complications were seen in any group

The addition of verapamil as an adjuvant to steroid did not result in significant improvement when added to epidural injection in patients with lumbar radicular pain. However, Successful outcome was better in verapamil group at 3 months.