Epidural Injection for Sciatica

Epidural Injection for Sciatica

 

The spine  (vertebral column) protects the spinal cord which extends from base of skull to tail bone.  Many nerves arise from spinal cord and connect all parts of body to the brain. These nerves provide sensation and mobility to all parts of body and limbs. The sciatic nerve is the largest nerve in the human body.  Sciatic nerve is formed by union of nerve roots arising from lower part of spine.

Why Does the Sciatic Nerve Cause Pain during a Slip Disc?

Sciatic nerve  comes out of intervertebral foramen in the spine and runs on each side of spine, passing deep in the buttock and back of thigh and leg till the foot.  It provides sensation to legs and helps leg movements.  Sciatica is the term used to describe the symptoms of leg pain, tingling, numbness, shock like sensation or weakness that travels down the low back in the back of the leg along the course of Sciatic nerve. Sciatica is a description of symptoms, not a diagnosis.

There can be many causes of Sciatica. Most common cause being slip disc. Human spine is made of 33 vertebrae which are connected to each other by facet joints, intervertebral disc and various ligaments. Intervertebral disc lies between two vertebral bodies and has 2 parts – outer tough annulus fibrosus and inner jelly like nucleus pulposus. Intervertebral disc act as shock absorber of body and helps in spine movements. With aging, the jelly like nucleus pulposus loses its fluidity and becomes hard. This is called disc degeneration which occurs in entire spine.

Lumbar disc degeneration may or may not cause back pain but decreases spine flexibility. In some cases, the outer annulus fibrosus may rupture or tear, causing the nucleus pulposus to bulge out of the disc and extrude in the spinal canal. This extruded disc in the lumbar spine can put pressure on the sciatic nerve roots producing symptoms of sciatica. The extruded disc also releases various chemicals called prostaglandins which irritate the sciatic nerve roots, producing symptoms of sciatica.

What Are Epidural Injections?

The epidural space encircles the spinal cord and is filled with fat, small blood vessels and spinal nerves emerging from spinal cord. In epidural injection, medicine (combination of Triamcinolone and Bupivacaine) is injected in the epidural space at the site of disc prolapse and nerve compression.

The exact location of injection is planned with help of MRI of spine and done in operation theatre using X Ray (C Arm) to identify the accurate level. It is done as a day care procedure whereby patient is discharged on the same day after procedure is over. There are various techniques to perform this injection. We at Spinalogy clinic, have devised a novel and innovative technique for this injection which is safe and highly effective.

How Are Epidural Injections Administered?

Prior to injection patient is asked to undergo few blood tests. The injection is done in operation theatre in hospital and patient is discharged within 2 hours of injection. The injection is given in spine localizing the site with help of X ray. The site of injection is sterilized with antiseptic solution and covered with sterile sheets.

The area is numbed with local anesthetic injection. A special needle is used to reach the target site with help of X ray. A dye is injected to confirm needle position and once confirmed, medicine is injected.  Post procedure patient is observed for 1 to 2 hours and discharged home.

The patient is advised to avoid strenuous activities after the injection and take relative rest.

Effectiveness of Epidural Injections in Treating Sciatica

Epidural injections provide relief from sciatica from few months to years. At Spinalogy clinic, our multidisciplinary approach in addition to epidural injection, provides long term relief from sciatica. The patient can mostly resume their normal activities within one month of completion of treatment.

Techniques Used at Spinalogy Clinic, Pune 

Spinalogy Clinic has devised an innovative technique for epidural injection where the medication is deposited close to the affected nerve as well as the affected disc. Conventional epidural injections deliver medications only near the nerve and hence the results are short lasting.

Our special technique for injection followed by multidisciplinary therapies provide long term relief. Our multidisciplinary therapies, consolidate the anti-inflammatory effect of injection and further reduce the swelling and inflammation at site of nerve compression.

If you are suffering from Sciatica and want long term relief visit Spinalogy clinic,Pune for evaluation and treatment.

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