The Comparative study of Effect of caudal & Lumbar Approach in epidural steroides injection in the treatment of acute radicular Low back pain: a randomized clinical trial

INTERVENTION: Intervention 1: Triamsinolon 40 mg, lidocaine 50 mg, and normal saline 10 ml, total volume of 13 ml, single injection at L5‐S1 space in sitting position. Intervention 2: Triamsinolon 40 mg, lidocaine 50 mg, and normal saline 10 ml, total volume of 13 ml, single injection at sacral hiatus in lateral position. Treatment ‐ Drugs Triamsinolon 40 mg, lidocaine 50 mg, and normal saline 10 ml, total volume of 13 ml, single injection at L5‐S1 space in sitting position Triamsinolon 40 mg, lidocaine 50 mg, and normal saline 10 ml, total volume of 13 ml, single injection at sacral hiatus in lateral position CONDITION: Neuritis or radiculitis Radiculopathy. ; Neuritis or radiculitis PRIMARY OUTCOME: Intensity of pain. Timepoint: 30 min,1 week ,and 1 month later. Method of measurement: Visual Analog Scale. INCLUSION CRITERIA: INCLUSION CRITERIA: radicular low back pain, age 20‐50 years, confirmed L5‐S1 disk herniation, indication for non surgical treatment Exclusion criteria: bleeding disorders, anticoagulant therapy, local infections, septicemia, hypovolemia, pregnancy, ankylosing spondilitis, low back pain more than 12 month duration, previous spinal surgery, untreated tubercolosis, addiction, spinal tumors, multiple sclerosis, history of diabetes, ASA more than II, unwilling to participate