Aerobic Versus Core‑Stabilization Training After Caudal Epidural Steroid Injection for Lumbar Disc Herniation: A Single Blind Parallel Group Randomized Controlled Trial

Objective: – To compare the effects of adding supervised aerobic or core stabilization exercise to physiotherapy on pain and function after caudal epidural steroid injection (CESI) in individuals with lumbar disc herniation (LDH) and radicular pain. Design: – Three-arm parallel-group randomized controlled trial with 12-week follow-up. Thirty-five individuals were divided into 3 groups. For 6 weeks, the control group received physiotherapy. The aerobic and stabilization groups received the same program, plus 20 minutes of exercise. The primary outcome was pain (Visual Analog Scale, VAS). Secondary outcomes included disability (Oswestry Disability Index, ODI), quality of life (SF-12), and back awareness (FreBAQ). Results: – Both exercise groups showed significantly greater improvement in VAS and secondary outcomes at 6 weeks compared with the control (P<0.05). The stabilization group achieved faster pain reduction by week 6 than the aerobic group. By 12 weeks, aerobic and stabilization outcomes were comparable and remained superior to those of the control group. Conclusions: – In patients with LDH, adding aerobic or core stabilization to CESI produced greater pain relief and functional improvement than CESI with physiotherapy alone. Core stabilization yielded quicker initial pain relief, though both approaches were similarly effective by week 12. These findings underscore the clinical value of exercise programs following CESI. © 2026 Wolters Kluwer Health, LLC. All rights reserved.