Lower back pain is one of the largest medical issues in the world. It can manifest in a variety of ways and is caused by anything from injury to disease. Sciatica, a series of pain symptoms, is one of the most common contributors to lower back pain. It occurs in the sciatic nerve, which stretches from the lumbar back region all the way to the calves. If traditional treatment options do not work, a doctor will try a procedure called a sciatic nerve block. This procedure attempts to block certain sensory information from the sciatic nerve to the brain. In this way, it is possible to reduce or entirely eliminate sciatic nerve pain.
What is sciatica and how can a sciatic nerve block help?
Sciatica is not considered a medical diagnosis, but rather a series of pain symptoms that often point to an underlying condition. This pain happens in the sciatic nerve, which is the largest nerve in the human body. It consists of nerve endings that start in the lower back, go throughout the hips and gluts, and proceed through the legs to the bottom of the calves.
The pain from this condition has a drastic range from mild to severe. The pain is often described as searing or sharp rather than an achy or throbbing sensation. Luckily, most cases of sciatica are resolved with traditional treatment options such as NSAIDs, a targeted exercise routine, as well as heat and cold therapy. However, you should seek medical attention immediately if you experience any weakness in the extremities, numbness in the thighs, or loss of bowel or bladder control.
The symptoms of sciatica are fairly well-known and are much easier to pinpoint than many other chronic pain conditions. The main symptom of sciatica is pain that radiates from the lower back to the glutes and down the back of a single leg. The other signs to be aware of when diagnosing sciatica include:
- Weakness in the legs or feet
- Burning sensation in the sciatic nerve
- Pain the in the back of the leg exacerbated by sitting
- Shooting pain that makes it difficult to stand
Since the sciatic nerve is so large, it is vulnerable to being injured in a variety of ways. Any injury along the sciatic nerve can cause sciatica, however, the majority of injuries occur in the lumbar spine region. Some of the most common forms of injury include:
- Herniated disc
- Degenerative disc disease
- Spinal stenosis
- Spinal tumors
- Osteoporosis and compression fractures
Treatment basics for a sciatic nerve block
A sciatic nerve block is a multi-functional treatment option. It serves to relieve pain for the patient as well as acts as a diagnostic tool to help find the underlying cause of that pain. Since the sciatic nerve is so large, there are numerous different areas that can be injected effectively, including the thighs, knees, and glutes.
A sciatic nerve block procedure relieves pain by turning off the pain signals being produced from the injured nerves. Essentially, it prevents the pain signal from reaching the spine or the brain from the affected location.
What to know before your procedure
There are minimal preparations required before you undergo a sciatic nerve block. If you would like to be sedated during the operation, which is not required, you will require someone to drive you home as well as you must not eat or drink six hours prior to the procedure. Otherwise, standard practices apply, such as needing to wear a gown and being asked to use the restroom before the procedure begins.
Before the procedure begins, a local anesthetic will be applied to the injection site. After numbing is complete, a nurse will position you on your stomach, back, or side depending on the injection site. A physician will then insert a needle into the area using fluoroscopic (live X-ray) guidance.
Contrast dye will then be injected to verify the correct placement of the needle as well as the proper allocation of the medication. If the doctor is satisfied with the placement, she or he will then inject the anesthetic. If there is a large amount of inflammation in the area, a corticosteroid could also be added to the anesthetic.
Once the injection is made, pain relief is almost immediate. If pain relief does not occur, it is possible that more injections will be needed. The other alternative is that the underlying cause is not associated with the sciatic nerve, which is one way this treatment helps diagnose the actual condition.
When the local anesthetic wears off after a few hours, the pain might return. There might also be some soreness around the injection site for the next day or two. The overall pain relief generally lasts one to two weeks, but in some cases, it can be permanent. If there are no complications, the patient will be able to return to their normal lifestyle within 24 hours.
Risks and side effects
A sciatic nerve block is considered a safe and effective treatment option to relieve sciatica. Even so, there are inherent risks to all medical procedures. Some of the most common side effects include:
- Soreness at the injection site
- Nausea, headaches, and vomiting
- Unexpected spread of the medication
- Medicating the wrong nerve if they are close together
There are other side effects such as infection and bleeding as well, but they are far rarer. Overall, a sciatic nerve block has relatively few risks and has the ability to provide immediate relief. It is an excellent option for those experiencing sciatic nerve pain, especially before considering major surgery.
What is sciatica to you and what do you do to manage the pain?