There are a number of reasons why people experience back pain. Back pain could flare up after an injury; the pain could appear seemingly out of nowhere. It can be short-lived (acute) or long-lasting (chronic).
One of the most frustrating parts of back pain is that it can be incredibly difficult to identify the source of the pain. However, sciatica is a type of back pain that is relatively simple to identify.
Sciatica typically starts with a herniated disc in your lumbar (lower) spine. When one of your discs gets worn down (either by injury or years of use) its soft center can push out from the hard, outer ring. When the disc herniates, it can place pressure on the nerves around it, causing a lot of pain specifically when it's the sciatic nerve that's affected.
The sciatic nerve is the longest nerve in your body. It starts in the lower back, then splits to run through the hips, buttocks, legs, and feet.
One of the most obvious signs of sciatica is pain that radiates from the lower back into the back or side of the legs. There may even be a slight tingling, numbness, or weakness in the leg or foot.
There are six common causes for sciatica:
- Lumbar herniated disc (as we discussed above)
- Degenerative disc disease (when the disc wears away)
- Isthmic spondylolisthesis (when a small stress fracture allows one vertebral body to slip forward on another)
- Lumbar spinal stenosis (related to natural aging and causes sciatica due to a narrowing of the spinal canal)
- Piriformis syndrome (if the sciatic nerve gets irritated by the piriformis muscle in the buttock)
- Sacroiliac joint dysfunction (when the sacroiliac joint is irritated)
Many people who suffer from sciatica will find relief after just a few weeks, without drastic surgical methods. Over-the-counter pain relievers can help, although we stress these should be short-term solutions. Switching between hot and cold packs can also help, in conjunction with safe stretching. Seek medical advice prior to this, however, so as not to worsen the problem.
There are patients who come into our pain relief clinics in Marrero, Metairie, and Covington, however, who suffer from chronic sciatica pain. For these patients, we do offer a treatment plan that allows them to avoid surgery: epidural steroid injections.
How epidural steroid injections treat sciatica
Because the source of sciatica is easily identified (it's the sciatic nerve that's irritated), an epidural steroid injection is incredibly effective.
During the procedure, we place an anti-inflammatory medicine into the epidural space that hugs the area around your nerves. This medicine can – and should – decrease inflammation of the nerve roots, and, therefore, reduce your pain.
The procedure is fairly straightforward. We'll give you sedation, and then, we'll numb the area of the injection site. Then, we use x-ray guidance to direct the epidural needle into the epidural space. We place a mixture of numbing medicine and anti-inflammatory into the space and directly on the nerve as it exits the vertebra.
Immediately following the procedure, you'll be monitored for up to an hour. You may experience numbness or weakness in your legs or arms for a few hours. The injection may reduce your pain in as early as 3-5 days, and may continue to improve your pain for up to two weeks following the procedure.
We recommend a follow-up visit after 2 to 3 weeks to determine if further treatment is needed. Typically, we find that these injections may need to be repeated for the best results.
Our patients see incredible results from these injections. Not only do the injections relieve pain, but they do so without the need for major surgery or dangerous drugs.
Contact the Southern Pain and Neurological team today to learn more about how you can relief your sciatica pain with an epidural steroid injection.