{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T06:24:27Z","timestamp":1787293467696,"version":"build-2736575974"},"reference-count":88,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pain Res."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Epidural steroid injection (ESI) techniques have demonstrated effectiveness in improving short- and intermediate-term pain and disability outcomes; however, their efficacy may vary depending on the specific approach used. This meta-analysis aims to compare disability and pain outcomes among different ESI techniques - transforaminal (TFESI), interlaminar (ILESI), caudal (CESI), and combined approaches - in patients with lumbar radiculopathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The authors searched PubMed\/MEDLINE, Scopus, and Cochrane from inception to December 16, 2025, in accordance with PRISMA guidelines. Studies comparing disability and pain outcomes between different ESIs were assessed. Random-effects meta-analyses were performed to estimate the pooled mean difference between treatment groups at different follow-up timepoints. Sensitivity analyses and publication bias assessments were conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 31 studies comprising 2,452 patients were included. Compared with ILESI, TFESI demonstrated significantly greater pain reduction at 2 weeks and 1 month of follow-up, as well as superior improvements in both disability and pain at 3 and 6 months. Compared with CESI, TFESI showed superior disability improvements at 2 weeks and 1 month, with pain outcomes remaining superior at 1 and 3 months; however, both disability and pain outcomes plateaued by 6 months. At 12-month follow-up, TFESI demonstrated improved disability scores compared with CESI, with no significant difference in pain outcomes. Across all follow-up timepoints, the combined TFESI\u2009+\u2009CESI approach was associated with significantly greater improvements in both disability and pain relief compared with TFESI alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TFESI demonstrated superior short- and intermediate-term improvements in disability and pain compared with ILESI, but its advantages over CESI remained inconsistent. Limited evidence suggests that the combined TFESI\u2009+\u2009CESI approach may offer additional benefits over TFESI alone. Further prospective randomized trials are warranted to better define the efficacy and long-term outcomes of the combined approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420261320804<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpain.2026.1904875","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T05:38:10Z","timestamp":1787290690000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of epidural steroid injections in the treatment of lumbar radiculopathy: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"7","author":[{"given":"Sebastian 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