When an individual has sciatica pain, it can be the result of numerous conditions. It can be from a herniated disc pushing on a nerve root, spinal stenosis from arthritis causing nerve root pinching, or possibly a ruptured disc that has sparked up a chemical irritation inflaming the nerve root.
Just pinching a nerve root in and of itself is not enough to cause sciatica pain. It may cause numbness and possibly some motor weakness, but not pain. It is in fact the inflammation sparked up around the nerve roots that leads to the burning, searing, electrical pain that we know as sciatica.
Therefore, the theory behind an epidural steroid injection is that the LA pain management doctor is able to apply the cortisone directly around the inflamed area and relieve the discomfort. The particular type of epidural known as a transforaminal epidural injection is the newest variation of an epidural. It is the most complicated of various types of epidurals.
The caudal epidural injection is technically the easiest, and an interlaminar epidural is slightly more difficult. The transforaminal epidural injection approach does not have a high risk profile associated with the injection, but it is the most difficult.
Most LA pain doctors have patients in the prone position, which is face down with their belly on a well padded table. A real-time x-ray known as fluoroscopy is used to guide the needle for the most accuracy possible. The objective of a transforaminal approach is to place the needle at the point where the nerve root actually comes out from the spinal canal. That’s where the typical pinching occurs of the nerve and the best place for the needle to be.
Once the pain management doctor is satisfied with needle placement, contrast is typically injected to ensure accuracy. Once the x-ray shows excellent flow of the fluid where it is supposed to be, the steroid medication along with numbing medicine is placed.
Multiple studies have looked at the effectiveness of transforaminal epidurals. Overall, they have shown that about three months of short-term pain relief is the norm. Between 75 to 90% of patients obtain significant pain relief from transforaminal epidural steroid injections. It may be that a series of injections is necessary, possibly three injections over a period of six weeks.
Overall, transforaminal epidural steroid injections represent an excellent method of pain relief in those with sciatica. The risk profile is fairly low, and the benefit may be a patient who needs less pain medication, becomes much more functional, and avoids the need for an operation.
If you are suffering from sciatica, or severe back pain, let the California Pain Network help you. The Network offers pain management Los Angeles trusts, with comprehensive options available.
Call (310) 626-1526 for more information and scheduling!