Epidural Nerve Root Block Injection - A Personal Experience
Nerve-root injections for relief of sciatica - a personal account
I had an MRI scan last June which revealed that I have 2 herniated discs one on top of the other.
For over 18 months I had been suffering from severe sciatica. My doctor had originally suggested physiotherapy but the physiotherapist read my MRI results and said I was wasting my time with this treatment until I got some good pain relief sorted out.
After a year of taking paracetamol and ibruprofen, I was prescribed Amytriptyline, an anti-depressant which, when given at low doses (10mg) acts as a muscle relaxant.
It does offer some relief for pain at night and helps you to sleep but it didn't work for me and I had it prescribed again at 25mg and finally started to get some sleep - but I woke every morning feeling like I had a hangover, which wasn't very nice when I had to be at work at 8am.
My sciatic nerve pain was in my back, my right buttock, my right leg and my right foot, pain was especially bad in my right calf and both hips. By the time of my MRI scan I had already had 12 months of severe pain.
I was suffering from what is usually referred to as sciatica and this was being caused by the 2 herniated discs at L4 & L5 at the base of my spine impingeing and presing down on my sciatic nerves.
Sometimes, sciatica might only last a day or two but on other occasions it can last for years. Thankfully, sciatic nerve root injections are a good way to achieve pain relief.
Sciatica itself is not an illness in its own right, it is always a symptom of underlying spinal problems.
Usually sciatica is symptomatic of injury to the spine.
Choices? Physiotherapy is an option
Initially, I opted for physiotherapy but with only limited success. I had a short pain-free period but the pain started again and this led me to see a neurosurgeon to determine the best course of action to get me out of pain. I should say that physiotherapy works for many people without any further action required. I just wasn't one of them!
After Physiotherapy Doesn't Work - Nerve Root Injection or Surgery?
I was offered a choice of surgery or nerve-root block injections.
Now whilst the latter sounds pretty awful, I decided that if I could delay surgery then I would.
I had the nerve-root injection into the nerve-root between lumbar 4 & lumbar 5.
Nerve-root block injections contain a mixture of local anaesthetic and steroid.
The anaesthetic numbs the nerve completely, whilst the steroid acts as a strong anti-inflammatory.
Do Some Research - Use the Internet
I went on the internet the week before just so I knew what to expect. The very idea of someone injecting a syringe into my spine gave me the shivers.
Unfortunately, there wasn’t a lot of information out there. It was all very brief and I was worried about whether it would be a painful procedure.
Bear in mind that I have now endured 17 months of sustained pain, unable to sleep without taking drugs. I still can’t lift anything heavy or bend forward.
Anything that would give me some relief from the pain was worth trying though although I headed for the hospital with some trepidation, I also did so hoping that I would soon be pain free (on my right side anyway).
Nerve-Root Block Injection - The Process
- MRSA Swabs – you will be asked to do depending on which hospital you are going to. I had a swab taken from my throat, nostril and groin (don't worry you do this all yourself - not invasive at all).
- I was then interviewed by the neurosurgeon who would carry out the injection. She explained exactly what she would do, The whole procedure would be done in the X-Ray room. She would be x-raying my back in real-time. This way she could guide the injection with accuracy into the nerve root.
- I would be given a number of local anaesthetics. These would feel like a sting but were necessary to carry out the nerve-root injection.
- The procedure would take about 15 minutes.
- My leg might go numb or tingly shortly after the nerve-root block injection.
- And finally, for some people the nerve settled down completely after a nerve-root block injection but some people might only get a few weeks or a few months relief before the pain returned. If this happened, surgery was the next course of action.
She then asked me which side of my back was worse. I said ‘right’ and she drew a symbol on the right hand side of my back.
In the X-Ray Room
You are asked to lie on your tummy on the bed. The X-Ray screen is beside you though you can’t see it as you will be resting your head on your arms in front of you.
The neurosurgeon will tell you that she is taking a ‘bearing’ based on the X-Ray. She will then draw lines on your back which she will use as a guide to exactly where she needs to inject.
She will then tell you that she is going to inject you with local anaesthetic into the area.
For me, this was no worse than a sharp nip a few times. I got a short pain in my right buttock but I think this was caused by my own nervous tension more than the anaesthetic.
After about five minutes, the neurosurgeon told me she was administering the nerve-root block injection and that I may sense some numbness or tingling but should experience no pain during the injection. She also told me that if I was in any pain, she would stop.
Thankfully, I suffered only a small amount of pain when she withdrew the needle but nothing too dreadful; just another sharp pain in my right buttock.
I was helped up from the bed and asked to sit on the side of the bed until I was ready to get up.
The tingling sensation lasts for about 5 minutes and you will be a little bit shaky (from nerves probably). I had to be accompanied for the procedure (though your +1 will not go into the X-Ray room with you) because you must travel home with someone and not use public transport (though I used a cab).
I was well enough to return to work the next day.
And so far, so good – my right side has felt a bit easier. The neurosurgeon told me I should notice some real relief within 10 days. The anti-inflammatory is a slow release drug, it is meant to last a while. I am hoping the sciatic nerve settled down enough to not give me any pain in the future.