One of the most common pain management procedures performed on a daily basis in America are lumbar epidural injections. They have been performed for over 60 years with many studies showing significant effectiveness for relieving pain from pinched nerves known as sciatica.
There are three popular methods of performing epidural steroid injections. All of these are performed as an outpatient, and in addition all involved numbing medicine plus cortisone to soothe the inflammatory reaction sparked up by the nerve root compression.
The first type of epidural is known as the interlaminar approach. This was the first type invented back in the 1950s, and involves an approach between the bones in the back of the spine known as the lamina. This approach has been shown to be very safe and effective, with pain relief occurring in approximately 75% of patients. Often times, a series of up to three injections may be necessary for optimal relief from the sciatica.
The newest type of epidural injection is known as a transforaminal epidural steroid injection (TESI). This injection involves placing the needle closer to the actual area where the nerve root is being pinched. Nerve roots travel from the spinal canal through the area known as the foramen, therefore the transforaminal injection places the needle in this particular region. There are some studies showing that transforaminal epidural steroid injections in the lumbar spine are better at pain relief than simple interlaminar injections. However, there also studies showing there is no difference in the good to excellent results achieved with these different procedures.
The third type of epidural steroid injection is known as a caudal epidural. This procedure involves placing the needle through the bottom of the spine through an area known as the sacral hiatus. With a caudal injection, the Arizona pain management doctor is able to inject a much larger amount of steroid, as the medicine is able to reach multiple pinched nerves such as in a patient with spinal stenosis. Results with caudal epidural injections have been in line with the other two methods, with the caveat that caudal injections are able to reach numerous nerve roots and not just one.
Complications reported with epidural steroid injections are unusual but they do occur. Therefore they cannot be ignored and include such issues as a slight risk of infection, nerve injury, bleeding or allergic reaction to one of the medicines used. There have been reports of both transient or permanent nerve root injuries due to epidural injections, and There also may be transient weight gain, water retention or elevated blood sugars due to the steroid medication used.
Overall, epidural injections for sciatica have been of huge benefit to a lot of suffering patients. The injections often allow individuals to avoid surgery, get back to work, reduce the amount of narcotic medications necessary for pain relief, and stay active. If you or a loved one is suffering from sciatica, you are not alone. 1% of the population at any one point in time has the same issue. Help is available with Arizona Pain Specialists, the most comprehensive pain management clinics in Phoenix.
Currently, Arizona Pain now has a new Phoenix pain management clinic, its fourth location around the Valley. The Phoenix pain clinics accept over 50 insurances, including Workers Compensation, AHCCCS, Medicare, major medical and self pay. Personal Injury Liens are accepted as well.
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