It’s been such a busy week I haven’t had time to review any one specific site, but here are the latest links to the best health and fitness blog carnivals:

Grand Rounds is up at Marianas Eye. As most of you know, this carnival features the best of this week’s medical blog posts.

Weight Management and Fitness Forum 19th Edition hosted by Weight Master. A compendium of well written articles pertaining to diet, weight loss, exercise, fitness, nutrition, and just general health information.

Carnival of Improving Life 14th Edition hosted by Improved Life. Quality articles on how people can improve their lives and better their careers. Subjects include finances, fitness, nutrition, productivity, relationships, personal growth, and general health.

Carnival of Healing hosted by Libido and Health. A weekly round-up of blogs featuring information about healing, healthy living, self empowerment, and spirituality.

Total Mind and Body Fitness Blog Carnival #54 Hosted by FitBuff This week there are a variety of articles to help you improve your brain power, dating, exercise, family, grooming, money, nutrition, sex, stress and work… you name it.

Enjoy!

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June 21, 2008

Sciatica and Epidural Injections

Here’s another good question from this week’s mailbag:

Hi Dean

After four weeks of severe sciatic pain and not being able to walk more than a few yards, I finally got in to see an osteopath last week. He said I might want to consider cortisone injections as part of the physical therapy. I read about epidural steroid injections in the forum but I’m wondering what you think of them.

Any advice would be appreciated.

Allen

My response…

Hi Allen,

I’m glad you asked this question because I’ve been meaning to address this subject for some time now. Initially, I was skeptical of the use of steroids or other pharmaceuticals for treating back pain because of my long history of being a natural health nut.

There was a time when I viewed anything coming from conventional medicine — and especially the big pharmaceutical companies — as some sort of toxic poison.

I’m still not crazy about “artificial ingredients” so to speak, but I’d like to think I’ve gotten a little smarter when it comes to science, medicine and health over the past few years.

Which Brings Us to Epidural Steroid Injections

My first experience with the therapeutic use of steroids came about in an unlikely and rather unpleasant fashion.

A couple years ago one of the family cats came home dragging her hind legs. She was obviously injured so we rushed her to the Vet. Long story short, he gave her a steroid injection and sent her home with oral steroids to be given daily for the next week. Within a few days she was back up and around like nothing had ever happened.

We still have no idea how she injured herself, but we were sure she was going to be crippled and would probably have to be put to sleep. Instead, she fully recovered.

That was a real eye opener.

Then Came the Knockout Punch

Not long after that Ken (a.k.a. krd) started posting in the forum his experience with the epidural injections and how they knocked down his sciatica symptoms like Muhammad Ali taking on Howard Cosell.

I couldn’t ignore the evidence after that.

So now I’ve come around 180 degrees on the subject of steroids for the treatment of sciatica. If your doctor is recommending them for you, I believe they are definitely worth a try.

Keep in mind that they don’t work for everyone. This is probably due to the fact that sciatica has many possible causes and simply eliminating the inflammation may not do the trick.

Also, keep in mind that the epidural will not heal anything. It only eliminates the inflammation and swelling, which should give you relief from the pain. This relief is your window of opportunity to proceed with physical therapy to correct the cause of your sciatica.

As always,
Dean

References:

1. Singh V, Manchikanti L. Role of caudal epidural injections in the management of chronic low back pain. Pain Physician 2002;5: 133-48.

2. Carette S, Leclaire R, Marcoux S, Morin F, Blaise GA, St-Pierre A, et al. Epidural corticosteroid injections for sciatica due to herniated nucleus pulposus. N Engl J Med 1997;336: 1634-40.

3. Koes BW, Scholten RJ, Mens JM, Bouter LM. Efficacy of epidural steroid injections for low back pain and sciatica: a systematic review of randomized clinical trials. Pain 1995;63: 279-88.

4. Watts RW, Silagy CA. Meta-analysis and the efficacy of epidural corticosteroids in the treatment of sciatica. Anaesthesia Intens Care 1995;223: 564-9.

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