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 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.