Sciatica Treatment Through Epidural Steroid Injection – Research Data Revealed

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Sciatica Treatment Through Epidural Steroid Injection

Sciatica pain is now a common condition, and thousands suffer from it every year. This has led to several researches and studies being conducted to find an absolute cure to the condition. Although medical experts and scientists have been unable to discover or invent a method of treatment that acts as an absolute cure, there are several forms of treatment that are known to work for relieving sciatica nerve pain in a patient. The symptoms of sciatica include acute pain that starts from the lower back and goes all the way down to the lower leg. This can make standing, sitting or any other type of movement very painful for the sufferer, thus adding to the overall discomfort.

However, some new research conducted by experts in this field has revealed that epidural steroid injections are capable of providing better relief to patients than Enbrel, a recently found anti-inflammatory drug. However, when the results of the two were compared, the differences between them were only modest, and no data suggested the superiority of one over the other. In a study that was conducted, an increased number of patients reported pain relief one month after being injected with these injections. This relief, however, did not last long when a period of six months was considered. This was almost equal to the relief offered by Enbrel. Additionally, a third form of treatment which was tested simultaneously was the usage of injections containing a local anaesthetic and saline.

Dr Steve Cohen, author of the study, is the director of pain research at Walter Reed Army Medical Center in Bethesda, MD and also a professor of anaesthesia at Uniformed Services University of Health Sciences. This study, which was published in Annals of Internal Medicine on April 17, clearly mentioned that the steroids proved to be better than both the other forms of treatment. Additionally, it was also said that Enbrel had almost the same effects as saline in short term. He said that there were several ideas about how epidural steroids work in people, and the effect that it had. While some agreed that these steroids were advantageous for the treatment of sciatica back pain, there were others who held that the effects were only seen in short-term treatment. Yet there were others who argued that epidural steroids were helpful in relieving back pain, but had no benefits for facilitating functionality. Dr Cohen also said that some people are of the opinion that use of steroids may help relieve a patient from pain, but it does not necessarily reduce the possibilities of invasive surgery.

As per the article, back pain is one of the most common causes that lead to disability in people under 45 years of age. While most health experts held arthritis or degenerative disks responsible for this, studies have led people to believe that nerve-related pain was also a factor that had been underestimated.

Dr Steve also added that treatment of sciatica nerve pain was quite difficult, and that epidural steroids have been in use for almost fifty years. However, even after years of being in use and scores of studies, the medical community still stands confused over the effectiveness of this treatment method.

The use of Enbrel

Of late, some researchers have advocated the use of Enbrel (etanercept) to treat sciatica nerve pain. This is because of a new belief that suggests the release of inflammatory molecules from degenerating discs, in contrast to the old belief that the compression of these discs on nerves caused sciatica pain. Nevertheless, these inflammatory molecules are called cytokines, and Enbrel, being an inhibitor, blocks their release. It must also be mentioned here that etanercept was, and is still actively used in the treatment of auto-immune disorders such as rheumatoid arthritis.

Despite this, Dr Roger Chou, chairman of the committee which wrote the lower back treatment guidelines in American Pain Society, said that there was not enough evidence to support the use of epidural etanercept for the treatment of sciatica nerve pain presently.

In a study that comprised of 84 individuals, all of whom suffered from sciatica pain and were in their initial phase, it was concluded that the use of transforaminal epidural steroids was more beneficial than using epidural saline for a short term period. The effect, however, diminished with long-term follow ups of the same treatment method. This clearly suggested that while there were a few differences, the results were not considerably different, and no obvious benefit was seen from the usage of epidural etanercept. Most importantly, patients involved in the study got better regardless of the form of treatment given to them.

Long term result?

Dr Chou also added that patients suffering from sciatica pain must understand that epidural steroids do not have long term effects, and that they can improve their condition even without the injection. He said that a large number of health experts and patients over-rated the effect of steroids, however, the evidence does not entirely favour this belief.

These injections are also associated with side effects and complications, some of which can be severe and prove fatal. This is also one reason why there is a limit on the number of injections a patient can take. Side effects include suppression of the immune system, increased levels of blood sugar and ulcers.

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