Spinal Injections In Sciatica Treatment

49 Comments

  • Bronwyn

    Reply Reply April 24, 2012

    Fantastic and timely ‘report’ about these injections. I’ve had one spinal injection and I have to admit it was the most wonderful ‘thing’ in the world to me at the time as I was desperately in need of some immediate pain relief. I was under no illusions regarding exactly what the injection was for and the treating doctor and radiologist were the most wonderful young men who treated me as very precious indeed. I am indebted to this method of ‘pain’ control for when things get out of hand as they had in my case, but this report just backs up my own knowledge about the need for inner core strengthening exercises and spinal stretching and strengthening exercises performed daily, as frequently as is possible and practical. I’ve purchased a wobble board to effect some inner core strengthening, and try to indugle in gently spinal exercise frequently during the day as these DO relieve a lot of pain if done correctly. I’m looking into the “True Back” gizmo which sounds as though it would be well worth purchasing however, being on below poverty level Disability Pension income, the cost plus postage to Australia is prohibitive to me so I may just have to devise something similar myself and try it out – any thoughts/ideas/advice re this please?

    • Dr. George Best

      Reply Reply April 25, 2012

      Although it probably does help relax the muscles along the spine by supporting the spine in the center channel, I think the main effect of the True Back is primarily due to the extension of the lumbar spine. This can be accomplished with simply lying on a rolled up towel placed in the small of the back. The McKenzie extension exercise does this as well, but lying down with the spine in extension is a good alternative and can give the arms a rest if they get tired when doing the McKenzie exercise frequently. You might be able to mimic the True Back’s muscle pressure effect by placing a couple of tennis balls in a sock and tying it off such that the tennis balls align on either side of the spine and then lie on this with a folded towel or other padding between the tennis ball device and the floor. Good luck!

      Dr. Best

  • Christopher Faustmann

    Reply Reply June 9, 2012

    Hello Dr. – Altho’ I’ve not been diagnosed , all signs ( pain ) seem to fit sciatica . I’ve had no injury(ies) to have caused this , I’m accepting it’s my body wearing out . It has been many years since I did yoga exercises on a daily basis. Your advice seems to lean in that direction .

    any thoughts .

    thank you.

    • Dr. George Best

      Reply Reply June 11, 2012

      In many cases there is not one single traumatic event that leads to sciatica or back pain, but instead there is a series of small injuries that occurs over a long period of time. Prolonged sitting, yoga poses that involve extreme spinal flexion, and numerous other things can contribute the the development of sciatica.

  • Mike Prouse

    Reply Reply July 3, 2012

    Dr. Best,

    I stumbled upon your site a few days ago and I’m so glad I did. I am a long time suffer of sciatica. I ruptured a disc more than twelve years ago and had a microdiscectomy. Since that time I’ve had many flare ups and until the last two years have been able to get things under control fairly quickly. However over the last two years I’ve had three incidences, two of which took nearly six month to return to normal activity with mild pain.

    Since my first incident with the ruptured disc, I have seen Doctors, PTs, Chiropractors, Arrosti and Nuerologist, performed hours of my own research and listened to the opinions of countless others, but none have offered the clear-cut information you provide.

    You have taught me how to tell if my sciatica is musle or structural, which exercise to do and (as important) which ones not to do, when to ice, when to heat, what exercised to do after I get the issue under control, and how to prevent future issues. I have spent more money on some of the products you have evaluted, with little results, than you ask for to join your site.

    I’m happy to say that following the information you’ve provided by icing, stretching and supplementing with OTC antiinflamatory medication my flare up is progressing toward healing.

    I look forward your e-mails and videos. You are by far the “Best” thing I’ve found on the Internet. I will encourage others to seek out your site and fine relief.

    In short, I just wanted to say Thank You!

    • Dr. George Best

      Reply Reply July 4, 2012

      Thank you for your nice comments, Mike. I’m glad you’ve found my site helpful.

      Good luck for continued improvement and remember to keep up with the preventive measures to keep things in shape once the symptoms are gone.

      Dr. Best

  • Matti Brown

    Reply Reply September 20, 2012

    I have to have a hip-replacement because of serious osteoarthritis, which showed absolutely no symptoms until I tripped over the leg of a white board and fell badly, 2 years ago. Then everything started screaming! I’ve been teaching yoga for 35 years but sadly have to succumb to the hip-replacement in Nov.
    Now I have self-diagnosed sciatica – I thought I would go out of my mind with the pain until I found you, George.
    Thank you from my heart for so generously sharing your knowledge. You are a god!
    Matti

    • Dr. George Best

      Reply Reply September 20, 2012

      Hi Matti,

      Thanks for your nice comment. I’m glad to hear that my information has been helpful. I’m sorry to hear you need a hip replacement, but at least it is a type of surgery that usually has a positive outcome.

      Good luck!

      Dr. Best

  • Catherine Hinsdale

    Reply Reply September 30, 2012

    Thank you for all of your helpful information. I’ve had 1 spinal injection & it lasted maybe 3 days.
    It might be great if it would work, but also comes with side effects on my bones & probably more
    problems I don’t want to know about.
    You are great at sharing of your knowledge.

    • Dr. George Best

      Reply Reply September 30, 2012

      You’re welcome, Catherine. I’m glad you’ve found the information helpful.

      Dr. Best

  • William Pierce

    Reply Reply November 3, 2012

    Hi, Just want to say thank you for all your informative Emails…keep them coming as I look forward to hearing from you from time to time. What about a chemopapain (sp) injection for herniated/bulging disc?

    • Dr. George Best

      Reply Reply November 14, 2012

      Hi William,

      Sorry about the delay in getting back to you. For some reason I did not receive a notification from the system about your comment. Anyway, I do not recommend chymopapain for treating herniated discs. While it is an effective treatment for many, there are considerable risks with the procedure and to my knowledge it was withdrawn from use in the U.S. in 2003 due to a number of deaths and serious medical complications.

      Dr. Best

  • dtroutman97@aol.com

    Reply Reply December 22, 2012

    Several years ago for lower back pain, not sciatica, I received 6 ESI at 6 different locations and appointments. None of these provided any relief. Then the same clinic ran me through several PT sessions, which also provided little, if any improvement.

    • Dr. George Best

      Reply Reply December 22, 2012

      ESIs do only one thing that potentially helps with back pain and/or sciatica: reduce inflammation. Depending on the relative contribution of inflammatory swelling to the overall nerve compression, ESIs may or may not have much effect. For example, in a case where there is a relatively small disc bulge with a lot of inflammatory swelling, an ESI (delivered to the right spot) can be very effective. On the other hand, when there is a large disc protrusion or rupture and the disc material is producing a lot of pressure on the nerve(s), swelling is less of an issue, so an ESI probably won’t do much.

      With regards to PT, there are a lot of treatment modalities that get lumped together under “PT”. To be effective, the treatment modalities need to be matched to the cause (or at least most likely cause) of a patient’s symptoms. A lot of times this is not the case because either the condition has not been properly diagnosed, or because the physical therapist is not experienced in treating the particular issues the patient has and just applies a “one-size-fits-all” approach to treatment. In addition, some of the “favorite” modalities such as electrical stimulation and ultrasound are, in my experience, minimally effective in most cases of low back pain and sciatica. They are probably used as much out of tradition (and in some cases probably profit motive) as for their therapeutic benefits.

      Dr. Best

  • Frank

    Reply Reply January 13, 2013

    Great information and very helpful/comforting. I have L4/L5 and SI joint issues causing sciatica. This is shown mostly in the lower left leg. Burning below the knee down to the top of foot, pain under the left part of the knee, pain in front of leg in the meaty part left of the shin. The longer I stand or work in garden the worse it gets. It never goes away. Is there any specific exercie you can recommend that I could try. (Assume I have tried quite a few) ….Stretching gives temorary relief………… Thank you

    • Dr. George Best

      Reply Reply January 14, 2013

      Hello Frank,

      Start with the testing of te various positions for the McKenzie exercise in my free ebook and see if you can find a position that works, then do that frequently (see the directions in the ebook). It is possible that your symptoms are being generated by contraction in the muscles of the lower leg, so the other thing I suggest is to press around in the muscles with firm pressure to see if yo find a sore point or a spot that causes increased symptoms in the area. If you find one or more such points, deep massage will usually help and you can either do self-massage or try a few sessions with a massage therapist to see if you can get it worked out.

      Good luck!

      Dr. Best

  • Lorraine Briscoe

    Reply Reply February 8, 2013

    .Thank you so much for your information and help It’s a blessing to have stumbled up on this site. I do have a reptured disc and was treated for this by one steroid injection which helped the pain, but left me with numbiness in my left baby toe.s . I am trying your suggessted exercises, and have noticed some inprovement , such as feeling in the area of numbness and my muscles in my leg. I was thinking about physical therapy, but don’t have the money. I will keep watching you site for more help.

    • Dr. George Best

      Reply Reply February 8, 2013

      In most cases, if you are consistent with applying the self-treatment methods you will be able to effectively manage the problem on your own. The key thing to remember is that even once the symptoms are gone, chances are the underlying problems are still there to some extent, so it’s important to continue the exercises on a preventive basis and be careful with activities like bending and lifting to keep the symptoms from returning.

      Good luck!

      Dr. Best

  • Mdm Norakmar rahman

    Reply Reply May 31, 2013

    Dr best. You r awesome..wow.Its 31 mei 2013..Hi..dr…I am from Malaysia if uve heard.. and i trully trully appreciate your precise and v v to the power of infinity. Useful of your feedbck. It is so useful n enlighten me. I pray of all as in here ur health. U r blessed person sir. Exercises warm pack..stretching are the vital daily maintence..n consistent. Tqvvvvm

    • Dr. George Best

      Reply Reply May 31, 2013

      You’re welcome. Thanks for the nice comment!

  • john lowndes

    Reply Reply May 31, 2013

    hello DR, i’ve found some great tips on treating my sciatica thanks to you! thankyou! about five years ago i had it really bad, i was not able to work for almost a year! but with a combination of exercises and two nerve blocks i got back on my feet! then i started going to the gym to get fit and loose weight! and all was good for about five years! then my mother took ill and i had to look after her and the gym got forgotten! anyway got fat and un fit again! whilst shifting something heavy and akward at work i’ve slipped another disck! been going on for nine months now! but i think i’ve got disc sciatica and periformus sciatica! is it ok to do both types of the exercises? john lowndes, leicester, uk.

    • Dr. George Best

      Reply Reply May 31, 2013

      Hello John,

      You can definitely do both the disc and piriformis exercises. When you have both, I recommend focusing more on the disc at first, because the nerve irritation from the disc will often cause the piriformis to contract. So the sooner you can get some pressure off of the nerve, the faster the piriformis will respond as well, but there’s no harm in also doing the piriformis exercise at the same time.

      Good luck!

      Dr. Best

  • Mark Rivera

    Reply Reply June 26, 2013

    I’m a 44 year old male and I have this pain that starts from my left buttock down the leg, knee and numbness on the sole of my foot. Any suggestion, seems to getting worse. It’s been about 2 months that I been dealing with thus issue. Any help would be appreciated.

    • Dr. George Best

      Reply Reply June 26, 2013

      Hello Mark,

      I suggest you start with the basic self-treatment methods found in my free ebook. If you don’t already have it, you can get it from this page:

      http://www.sciaticatreatmentathome.com/sciatica-treatment-exercises/

      If you don’t notice much improvement within a week or two, I’d recommend seeing a doctor and probably have an MRI to fully evaluate the lower spine (regular X-rays are usually not sufficient to fully evaluate the possible causes).

      Good luck!

      Dr. Best

  • mohamed metwaly

    Reply Reply July 15, 2013

    Dr. Best , just want to thank you for all yr informative Emails
    I am 60y (M) from Egypte my MRI report is as follows:
    *Spondylolisthesis with forward sliding of the body of LV4 relative to LV5.Compression of the related thecal sac and lumbar roots at L4-5 level due to local canal stenosis induced by vertebral sliding and associated disc bulge.
    *The remainder of lumbosacral thecal sac and roots are within normal.
    *Normal lower dorsal spinal cord, conus medullaris and cauda equina.
    *The lumbar vertebral bodies and their posterior arches are, otherwise, normal.
    Despite painful pains i do not take any drugs, i used to swim one hour daily (6 d a week)
    All signs (pain) seem to fit sciatica, this shown mostly in the lower left leg (sometimes right) pain under the left part of the knee, pain in front of leg pain between the left leg and lower part of stomach (in the joint between). is there any specific recommendation .I look forward to hearing from you. Thanks

    • Dr. George Best

      Reply Reply July 15, 2013

      Hello Mohamed,

      Unfortunately the MRI report did not indicate what Grade (severity) the spondylolisthesis is, because that can make a big difference in treatment recommendations. For example, extension is still usually beneficial with a Grade I, but it may increase symptoms in a Grade II, and it is completely contraindicated in a Grade III or IV.

      The best recommendation I can give you is to carefully test the various positions for the McKenzie exercises as discussed in my ebook. Application of cold packs per the ebook directions will also probably help. Hopefully you’ll be able to get some relief relatively soon. Once the major symptoms are down, it is a good idea to do some core strengthening exercises (such as crunches and/or pelvic tilts), as this is usually helpful for reducing stress around a spondylolisthesis.

      If you do not already have the ebook, you can download it from the link on the right sidebar of this page:

      http://www.sciaticatreatmentathome.com/sciatica-treatment-exercises/

      Good luck!

      Dr. Best

  • helen dempsey

    Reply Reply September 22, 2013

    Dr. Best,
    You are so informative. I have learned a lot fom you about sciatica. Sometimes stretching makes it worse. Why is that? I am taking ibuprophin for my pain. I also get pins and needles occasionally. Celebrex has also helped me, but it is not so easy to come by. Ice helps me more than heat. Any other suggestions would be appreciated. The pain I have right now is really awful!I have an appointment tomorrow with my primary doctor.
    Thanks
    Helen Dempsey

    • Dr. George Best

      Reply Reply September 23, 2013

      Hello Helen,

      Stretching will sometimes exacerbate symptoms when inflammation is present, particularly if you do things that place tension on the sciatic nerve such as with hamstring streteches. Since the anti-inflammatory medications and ice help, that does suggest that inflammation is a significant factor in your case. The best recommendation I can make in that case is to follow the relatively intensive use of cold packs as discussed in the ebook (about 10 to 15 minutes at a time every two hours or so that you’re awake). Use the exercises when you can do so without de-centralizing the symptoms (the concept of centralization is explained in detail in the ebook in the section on the McKenzie exercises).

      Good luck!

      Dr. Best

  • wayne huggins

    Reply Reply October 8, 2013

    What about prylotheropy injections? what are your thoughts as I am considering getting these injections for lower back pain..and knee pain.. W.

    • Dr. George Best

      Reply Reply October 8, 2013

      I assume you mean prolotherapy and while it can be beneficial for back pain, it’s unlikely to help with sciatica unless it’s related to scar tissue around the spine or associated with problems in the piriformis muscle. Prolotherapy essentially re-starts the inflammatory process in the hopes of getting improved healing in areas of soft-tissue damage. While it is effective for some people for things like back pain and knee pain, it doesn’t work for everyone and it sometimes increases symptoms initially before improvement occurs.

      Dr. Best

  • orval

    Reply Reply December 26, 2013

    THANK YOU FOR THE INFORATIOMN.

    ORVAL

    • Dr. George Best

      Reply Reply December 26, 2013

      You’re welcome!

      Dr. Best

  • anamitra hait

    Reply Reply January 30, 2014

    my mother is suffering from sciatica for one month.different treatment procedures like ift,ust,drugs,exercise,heat and cold pack have been tried but the tingling and numbness is not restoring.what should i do?

    • Dr. George Best

      Reply Reply January 30, 2014

      You didn’t say what, if any diagnostic procedures have been done. Sciatica is really just a symptom and is usually due to some other underlying condition. The most effective treatment will depend on the nature of the underlying condition. Since you said she has numbness and tingling, she may not even have sciatica. If the doctors have just been trying different treatments without making any serious attempts to determine the cause of the symptoms (which unfortunately is pretty common when it comes to the care of older people), my first recommendation would be to take a step back and do some diagnostic work to evaluate things, such as an MRI or CT scan for starters, and perhaps an evaluation with a neurologist if that has not already been done.

      Dr. Best

  • anamitra hait

    Reply Reply January 30, 2014

    yes dr best,only x ray has been done in case of my mother.but no sure proof has not been found.in skiagram only hypertrophy of condyles of l 5 and slight lumbar spondylosis has been seen.can spondylosis leads to sciatica?

    • Dr. George Best

      Reply Reply January 31, 2014

      Spondylosis (which is just another term for degenerative changes in the spine such as bone and ligament thickening and disc thinning) can lead to sciatica, but by itself it would have to be relatively severe to cause significant symptoms. It is unlikely that the x-ray findings you described are the primary cause of your mother’s symptoms. I suggest she have an MRI (or CT scan if MRI is contraindicated due to something like a metal implant of some sort) to further evaluate the spine. This type of imaging will give a lot more information than an X-ray and will hopefully give a better indication on how to proceed with treatment.

      Dr. Best

  • Linda

    Reply Reply February 24, 2014

    The pain I am experiencing now is different from previous episodes. Rather than having severe pain originating in the hip area and extending down the leg, mine began on the outer side of my left leg. Strangely, there is tingling, burning, pain to the touch, stinging, and numbness all at the same time. I do not have the sharp, extreme pain in the lower back/hip area that is normally associated with sciatica. Does this still fit the description of sciatica? Acetaminophen does very little to help with the pain. Ibuprofen works better, but after short-term use I tend to have nosebleeds, so I use it very sparingly. I am using your exercise suggestions and find them helpful, but have not been able to get totally pain free. I’m beginning to think this problem is going stick with me to the grave! Thank you very much for shedding light on this subject. God bless!

    • Dr. George Best

      Reply Reply February 24, 2014

      Sciatica can occur without low back pain, but with the symptoms being on the side of the leg (rather than the back of the leg), it’s probably not sciatica. With there being pain to the touch, the most likely suspect is a condition called meralgia paraesthetica, which is an entrapment of the lateral femoral cutaneous nerve between the front of the pelvic bone and the inguinal ligament. It is difficult to treat, although it usually does get better with time. It’s usually treated with anti-inflammatory medication, sometimes injections, and rarely surgery. The best alternative treatments are probably gentle stretching (the extension McKenzie position is usually somewhat helpful), acupuncture and massage therapy, but massage may initially make it worse. Like I said, it usually does get better with time, but it can take several weeks to several months. Hopefully it will calm down quickly in your case.

      Good luck!

      Dr. Best

  • John Morris

    Reply Reply March 24, 2014

    I have had (diagnosed) sciatica.I have tried some of your exercises earlier posted. Over a period of 3 years I have had four spinal injections. I don’t know why,but after my last one,everything seemed different.Pain gone from my back,some discomfort at times above my left hip,but nothing I would complain about.Radiologist said “we’ll see”. Myself,thanks for your initial suggestions,exercises and injection notes.

    • Dr. George Best

      Reply Reply March 24, 2014

      Some people get good long-term results with a procedure called “dry needling” which is basically an injection that doesn’t inject anything. Nobody’s really sure how it works but it’s theorized that it disrupts patterns of contraction in muscles and/or has an acupuncture-like pain relieving effect. It’s possible that your last injection just hit the right spot to have such an effect. Whatever happened, I’m glad to hear you’re doing better and hope it continues.

      Dr. Best

  • Sunil agarwal

    Reply Reply May 21, 2014

    Hello doctot

    I am suffering from back pain from last six months and not able to get any relif going to multiple doctors likeortho spinal gout and many more following there course still not very happy with there results they got my mri and ct done they say alingment is normal and very small bulge or protution is there in l5 its because of that its paining the symptons of my pain are pain in center of the right buttocks goes down the thies then to the calf and clafs become extream tight and while i walk its very pain full but as soon as i sit or lie down its normal kindly tell me is it a sciatica or some thing else and i have also started ulta sound therapy ans ift also from last 3 days still the pain is not in control kindly tell me what should i do

    • Dr. George Best

      Reply Reply May 21, 2014

      Hello Sunil,

      From your description, I’d say it is likely that you do have sciatica and it is probably due to the disc protrusion. Usually small disc bulges do not cause major symptom problems, but it is possible that your disc protrusion is one of those that gets significantly worse in the upright position when there is compression of the spine due to gravity. In recent years, it has been shown using the newer upright or loaded MRI systems that some mild disc bulges as seen on standard (lying down) MRI will become quite large protrusions that are visible on MRI done in an upright position or with the patient in a compression harness that simulates being upright.

      My suggestions for treatment are the same for any disc-related sciatica. Begin with the methods in the free ebook. Since you don’t have symptoms when lying down, it may be a little difficult to tell what position for the McKenzie exercises best centralizes the symptoms, so I suggest just starting with the straight extension position and see how that goes. If extension seems to make things worse, switch to straight flexion at first and if things improve you can try extension again later on. As per the instructions, the exercise usually works best if you do it frequently throughout the day initially. Applying cold packs every few hours per the ebook instructions may also be helpful. I would also suggest you ask your doctor/physical therapist about possibly trying intermittent traction/decompression to see if that provides any relief. The one other suggestion I have is to try a chiropractor or osteopath who does spinal manipulation because in some cases (even sometimes when there is a significant disc protrusion) the actual underlying cause of the symptoms is faulty joint motion in the sacroiliac and/or lumbosacral joints and correction of the joints can often bring immediate relief.

      Good luck!

      Dr. Best

  • Andrews Wife

    Reply Reply February 11, 2015

    My siatica nerve is damaged I can walk lay sit without being in runs if pain and un tears now its at the bottom of my right foot and its numb any ideas what I can do to fix it in in pain and cant take it anymore

  • Andrews Wife

    Reply Reply February 11, 2015

    Will the numbness in my foot evr be back to normal I really want the pain to go away in always in tears and could never do anything me and the hubby have a three year old lil girl I need this to be fixed please any suggestions

    • Dr. George Best

      Reply Reply February 11, 2015

      You didn’t say what, if any, formal diagnostic tests have been done to determine the cause of your sciatica (and what the results were), nor what, if any, treatment you’ve had so far, so I don’t have a lot to go on. Most people get improvement using the methods in my free ebook, which you can download at: . Numbness usually indicates a longer or more severe nerve compression and may take several months to reach maximum improvement (and may or may not go away altogether), whereas pain usually improves significantly within a few weeks using the methods in my ebook. If things do not improve significantly in that time frame, the next step would be to get an MRI or CT scan to evaluate the problem more thoroughly (if you haven’t already), and there is a possibility that surgery may be required to relieve the pressure on the nerve. Hopefully it won’t come to that, but in most cases, the problem can at least be significantly improved.

      Good luck!

      Dr. Best

  • Dixie Lee Eubank

    Reply Reply August 10, 2015

    I had the injections and it seems to have made it worse. The pain is not only in my back, but it moved down to my rear-end. I’m going to try therapy. What are your recommendations for that?

    • Dr. George Best

      Reply Reply August 10, 2015

      Injections commonly do temporarily increase symptoms, as the fluid volume of the injection will increase pressure on the nerve until it is absorbed by the body and begins to reduce inflammatory swelling.

      With regards to therapy, my recommendations are to focus on reducing inflammation and muscle reactions at first with modalities like cold packs and electrical stimulation. Ultrasound and traction can be helpful, but they can also increase symptoms if applied when acute spasm and inflammation are present. Stabilization and strengthening exercises may be needed eventually, but tend to make things worse during the acute stage, so it’s generally best to wait on those until the major symptoms are significantly reduced. Your physical therapist will need to assess where you are starting from to decide how to begin with treatment. If it seems like you’re getting a “one-size-fits-all” treatment plan, and you are not getting much improvement within a couple of weeks. I’d suggest trying a different therapist.

      Even with a good therapist, you can maximize your results by using the methods in my ebook between therapy sessions.

      Good luck!

      Dr. Best

  • theo ricci

    Reply Reply September 17, 2016

    I heard that the steroid injections can cause high blood pressure. What say you?

    • Dr. George Best

      Reply Reply September 22, 2016

      High blood pressure is a commonly reported side effect of steroid injections.

      Dr. Best

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