Sciatica is a term that describes pain in the low back, buttock, and/or along the leg or legs. It is due to irritation of the nerves that exit the spine at the lumbar area. There are a few causes for these nerves to become irritated, with the most common being either degenerative disc disease or narrowing of the space around the nerve.
Sciatica is very common, and can be debilitating. It can start out as acute, sharp, severe pain or as a gradual, constant ache. It can go from a mild discomfort to a type of pain so severe that it interacts with our ability to work, exercise, enjoy activities with our friends or family, and sometimes to even think.
For some people sciatica gets better on its own or with the aid of an exercise regimen. For others, other forms of treatment such as injection therapy become necessary to bring the pain level to a tolerable level, or resolve it altogether.
At Interventional Spine of Vermont, Dr. Caballero and Dr.Ivie offer multiple evidence-based treatments for sciatica, including interlaminar epidural steroid injections, transforaminal epidural steroid injections, or spinal cord stimulators. Make an appointment with one of our board-certified physicians and find out the best treatment course for your sciatica.
Epidural Steroid Injection for Sciatica
Epidural Steroid Injections have been clinically proven to relieve symptoms of sciatica in most people. The steroid is injected into space between vertebrae called the epidural space. Steroids relieve pain by decreasing inflammation and decreasing the production of neurotransmitters that carry pain signals to the brain.
Many times, the cause of the pain (such as a disc protrusion) will improve over time and an epidural injection or two are sufficient to get you back to having a normal quality of life.Other times, the condition that causes your sciatica does not change much over time. In this case, continuous exercise regimens, medications, and periodic injections are used to resolve or decrease your pain.
Epidural steroid injections are contraindicated in the setting of some bleeding problems, active infection, and current anticoagulation. Please let us know if you are taking anticoagulants currently or you have a bleeding disorder and we will discuss the best treatment option. Relief usually starts in 7-10 days after the injection and lasts an average of 4 months.
Spinal Cord Stimulation for Sciatica
Spinal cord stimulation is a medication-free treatment of painful conditions including sciatica. The pain treatment is based on interruption of signals that transmit pain. Although the entirety of the science of why this treatment works is not understood, there are many studies proving that this treatment is helpful in relieving pain and improving the life of many, many patients.
Spinal cord stimulation involves insertion of a small device under your skin (usually the buttocks) which is connected to a thin wire that is placed along your spinal column. This is done in the operating room with anesthesia. Our board-certified physicians, Dr.Ivie and Dr. Caballero, can help you decide whether this is a good option for you and explain the process in detail.