Spinal Injections and Drugs for Sciatica
Spinal injections are generally considered as a sciatica
treatment option after more conservative treatments
have been tried. If the patient is still experiencing
strong or debilitating pain after analgesic and anti-inflammatory
medication, physiotherapy and sciatica exercises, they
will be looking for a stronger solution like spinal
injections and drugs for sciatica.
Spinal surgery for sciatica is considered a last resort
treatment and will generally only be recommended after
all other treatment options have been exhausted; spinal
injections are a less invasive, conservative treatment.
Spinal injections also have a role in diagnosing the
exact cause of sciatica.
Injections are a more effective means of pain relief
than oral medication because the drug is delivered directly
to the site of the pain or inflammation. Stronger drugs
can be used because they don't have to go through the
digestive tract. Many patients get long-lasting pain
relief with spinal injections for sciatica while others
only get short-term or temporary relief. As a diagnostic tool, spinal injections for sciatica
can help to determine the site of the pain. By injecting
lidocaine or other numbing drugs, for example, into
a particular location on the spine, the doctor will
be able to determine whether that is the location of
the problem simply by whether the patient feels some
temporary pain relief.
This information is then used,
together with other results and conclusions reached
from the patient's medical history, physical and neurological
exams and any imaging tests that may have been conducted,
to determine the best on-going treatment.
There are different types of spinal injections that
are commonly used for sciatica pain relief. These include:
Epidural
Epidural spinal injections are most effective when the
sciatic nerve root is compressed. When nerves have been
compressed for some time, some swelling and irritation
usually occurs around the root of the nerve. During
an epidural injection, steroids, which are strong anti-inflammatories,
are injected into the space outside the covering of
the spinal cord, called the dura, in the area of the
sciatic nerve roots.
The steroids work to reduce the inflammation around
the sciatic nerve root, which causes the pain. Epidural
spinal injections appear to be most effective when administered
within a few weeks from the onset of sciatica pain.
Sometimes pain relief is achieved after a single injection
but usually two or three are required, given one or
two weeks apart.
Epidural injections have proved to be successful for
many sciatica patients; when used in conjunction with
physical therapy and ordinary pain medication, they
frequently eliminate the need for spinal surgery for
sciatica. They provide effective sciatica pain relief
for about 50% of patients.
Selective Nerve Root Block (SNRB)
This type of spinal injection for sciatica has a dual
purpose. It is mainly used to diagnose the specific
nerve root that is causing pain but also to give relief
from sciatica leg and back pain. One of the common places
that a nerve becomes compressed is where it leaves the
protection of the spine. Problems commonly found in
this location include bone spurs, herniated disc, calcification
and narrowing of the space.
These all cause inflammation and pain which may travel
down the leg. MRI is used to identify the nerve being
affected and an SNRB injection may be given to help
isolate exactly where the pain is coming from. In cases
of a herniated disc, A SNRB injection can also be used
as a pain treatment.
Apart from analgesics, other drugs that are used to
relieve the pain of sciatica include NSAIDS, either
over-the-counter or prescription types, which relieve
the inflammation that is often the cause of sciatica
pain.
Other prescription medication that your doctor may
give you could be stronger pain drugs, muscle relaxants
which will help to relieve the pain of muscle spasms,
antidepressant drugs which block pain messages to the
brain and help your body produce extra endorphins which
are the natural pain reliever in your body.
It is important that whatever spinal injections and
drugs that you are given for sciatica pain relief, you
follow the doctor's instructions fully. There are possible
complications following spinal injections, which your
doctor will explain to you. While taking prescription
medication, don't use any herbal remedies or supplements
without checking with your doctor.
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