OBJECTIVES: To compare the efficiency of percutaneous laser disc decompression (PLDD) and transforaminal epidural steroid injections (TFESI) in the treatment of lumbar radicular pain caused by intervertebral disc herniation as well as the impact on the serum level of inflammatory mediators and herniated disc retraction. STUDY DESIGN: The research took form of a prospective observational trial and was conducted in the Department of Anesthesiology, Resuscitation and Intensive Care of the University Hospital Osijek after being approved by the Ethical Committee, from 2020 to 2023. PARTICIPANTS AND METHODS: After meeting the relevant criteria and signing the informed consent form, the subjects were placed into two groups, depending on the contact of the herniated disc and the spinal nerve root, after which each group was further divided into two subgroups using a random number generator depending on the type of the procedure (TFESI and PLDD). Subjects were followed for six months using four measurement points. A Visual Analogue Scale (VAS) was used to assess the pain intensity. Five questionnaires were used: SF-36, ODI, Pain Detect, HADS and PSQI. We measured the serum IL-6 level, CRP, the number of leucocytes and the differential blood count. A control MRI was performed six months after the procedure. RESULTS: Both groups of subjects, regardless of the contact and the type of procedure performed, experienced significant pain reduction. In the group with contact, the subjects who underwent the PLDD procedure experienced a lot less pain than those who underwent TFESI. The group with contact who underwent the PLDD procedure showed a stronger correlation of higher intensity of pain with raised inflammatory markers than the group without contact. Both groups of subjects who underwent the TFESI procedure showed a correlation of higher pain intensity with significantly higher values for inflammatory parameters. No difference in neuropathic pain was observed in either of the groups. For subjects with contact, the PLDD had better results in improving the life quality and reduction of disability, while the TFESI proved to be more efficient for reducing disability in subjects without contact. Both methods were equally effective for the reduction of depression and improving the quality of sleep, while the PLDD reduced anxiety more effectively. A significant increase in the number of subjects without contact was observed after both the PLDD and TFESI. 9. SUMMARY 107 CONCLUSION: The TFESI and PLDD are effective methods in treating radicular pain caused by disc herniation. In certain measurements, higher pain intensity was followed by an increased level of inflammatory mediators. The herniated disc retraction was significant in both methods.