A New Look at Sciatica: X-ray Technology Brings Injections into Sharper FocusSciatica is low back pain that goes into the buttock and travels down the back of the leg. The most common cause of sciatica is pressure on a nerve from a protruding or herniated disc. The disc is a spongy or jelly-like structure between the bones of the spine. It acts as a cushion and shock absorber. Injury to the back or degeneration from aging can cause the disc to push out of its own space and press against the spinal nerve. Pain from sciatica can result.
Sciatica is a fairly common problem with some major side effects. Pain, change in sensation, and muscle weakness can result in disability at home and at work. Loss of work time and medical expenses can create a financial burden. For these reasons, doctors have been looking for better, faster, and less expensive ways to treat sciatica.
Steroid injections for sciatica have been used for a long time. The success of these injections ranges from 20 to 100 percent. Injections are often helpful, but they may only last three months. Today's new imaging technology is making a difference in the success rate of this technique. Using a type of X-ray called fluoroscopy, doctors can see where the needle is inserted and where the medication is placed.
In the past, injections into the spine have been performed blindly. In other words, doctors guided the needle according to their knowledge of anatomy, without actually seeing inside.
The new X-ray method is more accurate. It gets more of the medication to the place where the disc is squeezing on the nerve. Applying the medication to the site of nerve irritation has better results. It also has fewer complications. Being able to see where they're going has made it possible for doctors to work around any unusual structures or scar tissue.
Injections using fluoroscopy shows better results when treating sciatica. The long-term outcomes are even better when injections are followed by physical therapy and stabilization exercises for the low back.
Vijay B. Vad, MD, et al. Transforaminal Epidural Steroid Injections in Lumbosacral Radiculopathy. In Spine. January 1, 2002. Vol. 27. No. 1. Pp. 11-16.
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