The treatment of lumbar radicular pain frequently entails a combination of medications, therapies, and injections to manage pain and return patients to their daily living and work activities. Physical therapy can play a role in non-operative care of radicular pain to help restore appropriate movement and function. Saal evaluated patients with herniated discs with radicular pain and found that 90% had good to excellent results with aggressive therapy [ 15 ]. Not only can specific therapy help reduce pain, but it can also decrease the amount of time away from work[ 16 ]. Physical therapy plays an important role in treating patients with radiculopathies and is occasionally prescribed to alleviate associated back and leg pain [ 17 ].
Corticosteroid side effects may cause weight gain, water retention, flushing (hot flashes), mood swings or insomnia, and elevated blood sugar levels in people with diabetes. Any numbness or mild muscle weakness usually resolves within 8 hours in the affected arm or leg (similar to the facial numbness experienced after dental work). Patients who are being treated for chronic conditions (., heart disease, diabetes, rheumatoid arthritis) or those who cannot temporarily discontinue anti-clotting medications should consult their personal physician for a risk assessment.
Epidural injections can be performed from several different approaches; these include a caudal, interlaminar, or transforaminal approach. The approach your provider chooses is based on each individual patient’s clinical presentation, the personal preference and experience of the provider performing the injection, the desired outcome, and most importantly, the risks versus benefits of performing one type of epidural over another. Clinically, the purpose of all epidural injections is to place a mixture of steroid and local anesthetic at the source of the problem to decrease inflammation causing pain, and to promote healing and clinical improvement. The epidural steroid injection involves placing steroid medication in the inflamed area and significantly reduces nerve irritation thus improving pain. This treatment option has the potential to completely resolve pain and ultimately may prevent operative treatment.