Exercise after caudal epidural steroid injection for lumbar disc herniation
Comparative Efficacy of Physiotherapeutic Exercise Regimens Implemented After Caudal Epidural Steroid Injection
NA · Çankırı Karatekin University · NCT06956664
This trial will test whether adding aerobic or core‑stabilisation exercise to standard physiotherapy after a caudal epidural steroid injection helps adults with MRI‑confirmed lumbar disc herniation reduce pain and improve function.
Quick facts
| Phase | NA |
|---|---|
| Study type | Interventional |
| Enrollment | 42 (estimated) |
| Ages | 18 Years to 70 Years |
| Sex | All |
| Sponsor | Çankırı Karatekin University (other) |
| Locations | 3 sites (Çankırı and 2 other locations) |
| Trial ID | NCT06956664 on ClinicalTrials.gov |
What this trial studies
This single‑centre, three‑arm, parallel‑group randomised controlled trial will recruit adults aged 18–70 with MRI‑confirmed lumbar disc herniation who received a caudal epidural steroid injection within the prior two weeks. Participants are randomised (1:1:1) to receive standard physiotherapy (heat, therapeutic ultrasound, TENS) alone or combined with either a moderate‑intensity aerobic programme or a progressive lumbopelvic stabilisation programme, delivered three times weekly for six weeks. Outcomes focus on pain, disability and quality of life measured at predefined follow‑up points to determine comparative short‑term and medium‑term benefits. Allocation concealment and standardised supervised sessions are used to minimise bias.
Who should consider this trial
Good fit: Adults 18–70 years with MRI‑confirmed lumbar disc herniation who had a CESI within the past two weeks, report pain ≥3/10, are medically cleared for moderate exercise, and can attend supervised physiotherapy three times weekly are ideal candidates.
Not a fit: Patients with neurological red flags (e.g., cauda equina), uncontrolled systemic disease, prior surgery at the affected level, contraindications to exercise, inability to attend supervised sessions, or who did not receive a recent CESI are unlikely to benefit from this protocol.
Why it matters
Potential benefit: If successful, adding a targeted exercise programme after CESI could prolong symptom relief, accelerate return to function, and reduce disability from lumbar disc herniation.
How similar studies have performed: Prior studies indicate that early structured exercise after epidural injections can improve pain and function, but direct head‑to‑head comparisons of aerobic versus core‑stabilisation programmes are limited, so this specific comparison is relatively novel.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Age 18 to 70 years. * MRI-confirmed lumbar intervertebral disc herniation. * Has received a caudal epidural steroid injection (CESI) within the past 2 weeks at Çankırı State Hospital. * Low-back or leg pain intensity ≥ 3 cm on a 10-cm Visual Analogue Scale after the injection. * Medically cleared for moderate aerobic and core-stabilisation exercise (no cardiac or orthopaedic contraindications). * Able to attend supervised physiotherapy three times per week for six weeks. * Willing and able to give written informed consent and to comply with study procedures. * Sufficient Turkish literacy (minimum primary-school education) to complete questionnaires. Exclusion Criteria: * Uncontrolled systemic disease (e.g., poorly controlled diabetes mellitus, congestive heart failure, active hepatitis C or other significant liver disease). * Neurological red flags such as myelopathy or cauda equina syndrome. * Previous lumbar spine surgery at the affected disc level. * Current pregnancy or planning pregnancy during the study period. * Severe musculoskeletal, cardiovascular, or respiratory condition that precludes safe exercise participation. * Use of systemic corticosteroids or opioid analgesics that cannot be stabilised for the duration of the trial. * Ongoing litigation or workers' compensation claim related to low-back pain. * Inability to communicate effectively with study staff or to follow instructions.
Where this trial is running
Çankırı and 2 other locations
- Çankırı Karatekin University — Çankırı, Turkey (Türkiye) (ACTIVE_NOT_RECRUITING)
- Çankırı State Hospital — Çankırı, Turkey (Türkiye) (RECRUITING)
- Çankırı State Hospital — Çankırı, Turkey (Türkiye) (RECRUITING)
Study contacts
- Study coordinator: Ceyhun Türkmen, PhD
- Email: ceyhunturkmen@karatekin.edu.tr
- Phone: +90 376 218 95 00
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions: Intervertebral Disc Displacement, Low Back Pain, Radiculopathy, Caudal Epidural Injection, Exercise Therapy, Aerobic Exercise, Core Stabilization