Steroid Spinal Injections Found to Ease Woman’s Neuropathic Pain
Steroid injections into the spine — similar to the epidural injections often given during childbirth — were effective in controlling pain as a result of nerve damage in a 32-year-old woman with Sjögren’s syndrome, according to a case report.
The report, “Lumbar interlaminar epidural steroid injections for chronic low back- and lower extremity-pain in Sjogren’s syndrome: A case report,” was published in the International Journal of Surgery Case Reports.
An autoimmune disease, Sjögren’s syndrome is mainly characterized by symptoms like dry eyes and dry mouth due to the glands it affects.
But some patients have neurological complications, which are mainly thought to be driven by inflammation occurring near nerves and interfering with their normal function. About 10–15% of people with Sjögren’s experience neuropathic pain — pain caused by nerve damage — as a result of their condition.
Researchers in Indonesia described the case of a 32-year-old woman with Sjögren’s who was treated at the neurosurgery department at Intan Medika KIM Hospital in Pangkalpinang, a provincial capital city.
The woman, diagnosed with Sjögren’s three years earlier, had tested positive for a number of self-targeting antibodies associated with the autoimmune disease. Specifically, she showed anti-nuclear, anti-Ro, anti-La, and anti-dsDNA antibodies.
She went to the hospital complaining of chronic lower back pain, along with pain in both legs that radiated from the spine and hips, down the legs to the feet.
She also reported numbness and feelings of abnormal sensitivity causing pain. On a scale of zero to 10, the woman rated her pain an eight.
Her lower back pain previously was associated with disease flares, the researchers noted, but it “had significantly worsened over the previous 1–2 months,” causing “limitations in her daily activity and living patterns, as well as her quality of sleep.”
CT scans also showed multiple protruded discs in the cervical and lumbar spine areas, but she was not considered a candidate for spinal surgery.
To alleviate this pain, the woman was treated with epidural injections of anti-inflammatory steroids between two lumbar vertebrae. This procedure works to numb the lower half of the body.
Within 10 minutes of receiving the injection, she rated her pain as between zero or one. The patient was also given “post-procedures education which includes life-style modification such as water-exercise to strengthen her extremity muscle, the use of lumbar-support for prolonged activity and body weight reduction,” the researchers wrote.
No side effects were evident through two years of follow-up.
“The use of lumbar interlaminar epidural steroid injections for an alternative therapeutic for neuropathic pain in SS [Sjögren’s syndrome] gives a satisfactory result in terms of improvement of pain as well as a significant improvement on patients’ quality of life,” the team concluded.