Evaluating Exercise Programs Added to Physiotherapy After Caudal Epidural Steroid Injection for Lumbar Disc Herniation

What this Trial Is About

Lumbar radicular pain caused by intervertebral disc herniation is often treated with a caudal epidural steroid injection CESI, which provides short-term relief by reducing inflammation near affected nerve roots. However, many patients continue to experience pain and disability, indicating that medication alone does not fully restore function. This trial aims to compare the effects of adding two types of exercise programs to standard physiotherapy after CESI to improve pain, disability, quality of life, and body awareness in adults with lumbar disc herniation. Participants will begin treatment two weeks after receiving CESI, starting with a two-week wash-in period. They will be randomly assigned to one of three groups conventional physiotherapy alone heat, ultrasound, and TENS, conventional physiotherapy plus supervised moderate-intensity aerobic treadmill walking, or conventional physiotherapy plus a phased core-stabilisation exercise program focusing on deep trunk muscle activation progressing to dynamic tasks. Each intervention lasts six weeks with three supervised sessions per week. Throughout the study, participants will be assessed at baseline, after the six-week intervention, and at three and six months to measure changes in pain intensity, back-specific disability, health-related quality of life, and lumbar body awareness. Researchers will monitor safety by recording adverse events and exercise tolerance. The study will last approximately six months per participant, aiming to identify the best exercise approach to support recovery following CESI for lumbar disc herniation.

Exercise Therapy After Caudal Epidural Steroid Injection