Injections For Sciatic Nerve Pain – Behind The Scenes

In this post, I will discuss injections for sciatic nerve pain.  Sciatica is the term for pain that travels along the sciatic nerve.  This pain can be very challenging and at times debilitating as I know all too well.  If you are reading this, you are probably looking for ways to combat this pain, and injections are definitely one way to provide some much-needed relief.  So, if you are interested in the basics behind the procedure, please continue reading.

About sciatica

On a basic level, sciatica is the pain you feel along the sciatic nerve, which travels from the lower spine down your legs.  The sciatic nerve is the largest nerve in the body.

Many conditions, including a herniated disk, can put pressure on the nerve roots coming out of the spine.  This pressure can lead to pain, numbness, or tingling along the path of the nerve.

Sciatica is not a diagnosis, but a symptom of a more significant problem in your spine, like a herniated disc.

For me, this pain radiates down my right leg.  I feel pain in my calf, ankle, or toes. Depending on where the nerve is compressed, that dictates where you feel the pain.

As I mentioned, and many of you may already know, sciatica can range from annoying, to severely painful.  I have chronic sciatica, and I can tell you it is no fun at all.

I have tried injections, and I want to talk about what this procedure involves.

One option for treating sciatica is lumbar epidural steroid injections

Epidural injections are often used to treat sciatica.  Inflammatory agents in the body, associated with back problems, like a herniated disk, can cause pain and trigger inflammation, which can produce nerve root irritation and swelling [1].

Inflammation can compress and irritate the sciatic nerve, and people often feel pain in the butt, or down the leg.

The job of the steroid is to block the inflammatory response from chemical and mechanical (herniated disk) sources of pain. By preventing the body’s response with an injection, you may be able to minimize the pain associated with inflammation.

Basically, the idea behind epidural steroid injections is to reduce inflammation and relieve pain.

Epidural steroid injections deliver anti-inflammatory medication directly to the source of pain, which is different from oral medicines that do not focus on a targeted area.  Oral meds are dispersed and are not as hyper-focused on the specific area where the pain originates.

The injection is placed into the epidural space.  Okay, what on earth is the epidural space?  Well, I am glad you asked.

Here is some detail on what the epidural space is.  The dura surrounds the spinal cord and epi means “outside of.”  So, the epidural space is the outermost part of the spinal canal. See, that wasn’t so bad.

What’s in the shot?

The actual chemical mixture of the injection may include local anesthetic, and/or saline, along with a steroid.

The local/saline mixture is to help give some immediate relief, as well as flush out any inflammatory materials that may be causing or intensifying the pain.  Think of this as a little bit of house cleaning while they are in there.

Typically, cortisone is used in the injection.  Cortisone is a synthetic version of cortisol, a steroid produced by the body’s adrenal glands [3].  Cortisol helps to keep inflammation down in the body. Cortisone is a potent anti-inflammatory medication.

The steroid itself usually takes a few days to a couple of weeks to kick in.  This is what my doctor told me when I had mine.

The equipment used

The doctor will typically use x-ray equipment and contrast (x-ray dye) to make sure the injection is put in just the right spot.  The x-ray lets the doctor see where they are going with the needles.  Yes, there are needles involved.  The dye shows up on the x-ray, kind of as a test to make sure they are putting the medication where it is intended to go.

With the help of these tools, the doctor is able to pinpoint the right spot and make the best possible experience for the patient, or at least that is the idea.

How often can you get a shot?

It is generally recommended no more than three procedures per year.  If you notice some improvement after the first injection, the doctor may perform another reasonably soon, to see if additional pain relief can be achieved.  The Mayo Clinic says the limit is due to steroid injections disrupting your body’s natural hormone balance.

Do they work?

This is a tough question to answer, some people receive pain relief, and some do not, every person will react in their own way.  So, it’s a really tough question to answer, I wish I could say definitively.

In my experience, I felt relief almost immediately, but that was the local anesthetic, and that wore off soon enough, like within an hour.  After that, I was still feeling the same amount of pain as before I had a shot.

This has happened on multiple occasions for me.  Yes, the doctor used x-ray equipment and dye to make sure it was the right spot, but for me, it just didn’t work.

Any benefit you receive will depend on your condition, how severe your injury is, and just how your body reacts to the medication.

As I mentioned earlier, the purpose of the injection is to reduce inflammation and relieve pain.  This is not a long-term, or permanent fix, but is designed to allow you to work through the source of the problem with physical therapy or exercise program.

So, the injection is not intended to be a permanent fix.

How long do they last?

This again depends on the individual.  Some people find short-term relief, while others can feel pain relief for up to one year.

Contraindications

Contraindications are basically medical conditions that would make you a poor candidate for a procedure like this.

Examples of contraindications could be:

• Certain drug allergies
• Certain medications you may be taking
• Pre-existing conditions

You will need to talk to your doctor about your medical history to make sure you are a candidate for this procedure.

Your doctor will prepare you for changes to your everyday routine if necessary.  For example, if you are going to be sedated for the procedure, which is not very common, your doctor may ask you not to eat or drink for a certain amount of time before the procedure.

Where does the procedure take place?

Typically the epidural steroid injections are performed where you would most likely think, a doctor’s office, hospital, pain clinic or surgery center.  If the procedure is going to be done in the back of a van in an alley, RUN!

Conclusion: Injections for sciatic nerve pain

I hope this post has helped you to gain an understanding of injections for sciatic nerve pain.  This is one treatment option available to help reduce inflammation and relieve sciatica pain.

It would be nice to be able to tell you the epidural steroid injections will for sure work, but that is just not the case.

Unfortunately, this procedure does not work for everyone, as it has not worked for me.  I have been through this a few times and have received no relief.

I know other people who swear by injections and are feeling great shortly after and return to their normal activities.

Everyone’s body will react differently to the treatment.  The jury is still out on the effectiveness of these injections.  Some people receive relief right away, some in a few days or weeks.

If you are looking for a non-surgical treatment option, and you have not tried a cortisone shot, I would talk to your doctor and see if you are a candidate.  You never know, this may be the treatment that ends up working for you.