A nerve block for sciatica is a moderate injection-based treatment option commonly used for a host of lower back and leg pain conditions. In this specific instance, the injection is given into the lower lumbar spine in order to mitigate the symptoms of sciatica complaints. Nerve blocks are some of the most widely utilized types of epidural injections throughout the back pain treatment sector.
Nerve blocks are popular with doctors and patients alike, but for very different reasons. Although they can be effective, these injections certainly demonstrate a variety of negative characteristics that should make every patient think twice before acquiescing to invasive care.
This focused essay explores the use of long lasting epidural nerve blocks for sciatica sufferers. We will detail the positive aspects of this particular form of injection therapy, as well as provide a balanced view of the limitations and downsides of treatment.
When performed correctly, nerve blocks can be very effective at reducing the severity of sciatica pain in many patients. Nerve blocks deaden the nerve’s ability to signal correctly, making it incapable of sending pain messages to the brain. The cocktail of drugs in most epidural nerve blocks consists of hormones, steroids and a long-term anesthetic agent. These compounds work in different ways to essentially mitigate discomfort and neurological symptoms in the buttocks, legs and/or feet.
In ideal circumstances, the positive effects of nerve blocks can last 2 to 3 months. A small minority of patients cite relief lasting 4 to 6 months. The potential for 6 solid months of decreased pain is very appealing for patients with chronic sciatic nerve suffering. Since doctors love giving these injections, usually all it takes is the hope for such improvement to get the patient on board for one or more rounds of injection therapy.
Physicians cherish these treatments, since they are quick to administer and are highly profitable, especially when the doctor can bill for “extras” such as the use of fluoroscopy for maximum injection precision. Doctors have certainly added nerve blocks into the "average" progression of ever-more invasive therapies for persistent dorsalgia complaints. Typically, these injections are provided once more conservative methods begin to fail or after several unsuccessful attempts at noninvasive therapy. If nerve blocks are not enough to end the pain, the doctor will usually recommend spinal surgery for most patients eventually.
Under ideal circumstances, epidural nerve blocks can be very effective, but in many instances, patients do not enjoy these types of results. At least half of the total number of nerve block recipients do not enjoy more than a single month of improved symptomology following each injection. This is especially true after multiple rounds of nerve block therapy. Some patients do not enjoy more than a few days or weeks of relief from similar therapeutic interventions. A few patients do not cite any noticeable relief at all after the treatment. Unfortunately, there is no way to ascertain how any given patient will react to any particular round of epidural nerve block therapy. Some patients report great results from their first injection, but virtually no relief provided thereafter.
Even when epidural nerve blocks work well and provide lasting relief for several months, eventually the patient will suffer pain again and will be confronted with the exact same treatment scenario as before. Do they choose another round of injection therapy? If so, for how long can they continue on this path? How many shots will the doctor allow before changing their recommendation to one leaning towards surgical intervention?
The point of this section is simply that even when all goes well and the patient benefits from the injection, no lasting solution has been provided and the patient will be placed in the same position of choosing a treatment path repetitively. Nerve blocks for sciatica are never curative and only qualify as symptom-targeting care, at best.
Limitations of nerve block treatment do not begin to tell of the potential true downsides of epidural therapy. Therefore, in order to provide a comprehensive and balanced view of this treatment option, we warn patients to be well aware of all the many significant risks associated with this path, including all the negative factors cited below:
All epidural injections can do lasting damage to the spinal anatomy. Some of the typical consequences include damage to the spinal nerves or spinal cord, rupture of intervertebral discs, or damage to the spinal meninges that might result in cerebral spinal fluid leaks. All of these potential consequences are more common when the doctor administering the injection does not utilize fluoroscopy technology.
Allergic reaction is common and may become severe or even life-threatening. Infection is also possible and can create the ideal circumstances for such serious health conditions as discitis or meningitis.
Some patients have bad reactions of an idiopathic nature to epidural injections and cite much worsened pain after treatment. Post-procedural pain escalation affects at least 10 to 20% of all patients and tends to linger in about 40% of those affected.
Maybe it’s not the worst immediate physical consequence, but the simple fact is that once patients tend to begin epidural nerve block therapy, they are herded towards eventual spinal surgery. Since back surgery is to be arduously avoided whenever possible, simply starting with nerve blocks might be counterproductive, especially since the patient should already know that the best they can hope for is temporary respite from pain with an eventual, and possibly very quick, return to agony.