Epidural Clonidine Versus Corticosteroid for Low Back Pain

Low back pain is a common condition, affecting majority of the adults in the United States
at some point in their lives. Fortunately, most resolve, even without treatment. However,
some suffer from continued or recurrent pain.

For those suffering from continued or recurrent low back pain, numerous treatment options
exist. One such option is an epidural injection, particularly when other non-surgical
treatment options have failed. An epidural injection is the placement of a needle into the
space around the spinal cord with the aid of a live X-Ray machine, followed by an injection
of various medications. Typically, the medication that is injected is a steroid, commonly
with the combination of local anesthetic medication. Epidural steroid injections, with or
without local anesthetic is part of the established standard of care in the United States
for those with continued or recurrent low back pain. The steroid is believed to reduce
inflammation and edema of the injured or irritated nerves. However, despite the routine use
of epidural steroids, the steroid itself is not without risks or side effects. Though rare,
the steroids have been associated with complications including osteoporosis, steroid induced
myopathy, cataracts and many others. In order to minimize the side effects associated with
epidural steroids, limiting the dose and frequency have been outlined.

Clonidine is another medication, commonly used in numerous clinical settings. U. S. Food
and Drug Administration approved the medication for epidural use for cancer pain but studies
have shown effectiveness in non-cancer pain was well and is routinely used for various
conditions. There is growing evidence on the use of epidural clonidine for treatment of
pain, including low back pain.

This research will study and compare the effectiveness, if any, of clonidine compared to
steroid in an epidural injection for low back pain.