Published on September 29, 2024
For many people with sciatica, this nagging, ongoing pain can cause them a lot of pain.
Sciatica is pain that radiates down the leg due to inflammation or pressure on the sciatic nerve. Sometimes it spreads from just the lower back to the buttocks, but often it reaches the outer calves and feet.
Sciatica may result from a herniated disc, herniated disc, bony stenosis of the nerve root canal, disc leakage, or other causes.
A common cause of sciatica is a bulging, herniated, or herniated disc. Experienced interventional pain management doctors know that even a simple herniated or bulging disc can be the source of back and leg problems.
A bulging or herniated disc is a sign of disc degeneration. A bulging disc occurs because the disc structure is damaged and cannot function properly.
As the disc “pancakes” outward, it may contact and irritate nearby nerve roots. As the disc continues to deteriorate, chemicals may leak from it. This can lead to inflammation of the peripheral nerve roots, which can lead to sciatica.
MRI is the primary diagnostic tool and gold standard for detecting the source of sciatica. This research, if correctly understood about a patient’s exact pain, could help diagnose the exact source of pain and thus determine the correct level of treatment.
Epidural steroid injections are often used to treat sciatica. To relieve inflammation, high concentrations of steroids (anti-inflammatory drugs) must reach the inflamed nerve roots.
Treatment success is maximized when these injections are performed under X-ray guidance (fluoroscopy). This allows doctors to guide the path of the needle to the exact target, ensuring the drug reaches the precise location along the affected nerve.
Injections usually do not require anesthesia. However, local anesthetic injections along with steroids can temporarily relieve pain.
When a simple midline epidural is given, the medication may not get close enough to the irritated nerve root. Therefore, skilled pain management physicians frequently perform transforaminal epidural steroid injections.
This technique places a concentrated dose of steroids next to the stimulated nerve. It usually involves testing several existing nerve roots to see which one is most affected.
Once the problematic nerve root is identified, steroids are used to “switch off” the inflammation that is causing the pain. This very selective epidural injection ensures that the drug reaches the affected nerve root in the highest possible concentration.
Transforaminal steroid injections may also be used to treat sciatica in patients who have had previous back surgery but still have persistent or recurring leg pain. Alternatively, it could be used to treat sciatica in patients taking blood thinners because the needle does not enter the central spinal canal.
Medical research shows that leg pain associated with lumbar disc herniation can often be successfully treated with epidural injections.
In fact, there is no difference in long-term (6 months to 1 year) outcomes between injections and physical therapy versus surgery for conventional disc herniation.
However, if injections are not successful in relieving your pain, one option may be minimally invasive spinal surgery, which can easily remove the disc herniation, relieve pressure on the nerves, and allow you to return to work within a few days.
Transforaminal epidural anesthesia and minimally invasive disc surgery have revolutionized pain management. These advanced technologies have allowed many patients to return to relatively pain-free lives.
We find that many patients with long-term sciatica are unaware that this procedure can resolve or minimize discomfort that lasts for months or even years.
