Sciatica is commonly caused when a herniated disc or narrowing of the bony opening for spinal nerves (foraminal spinal stenosis) compresses a nerve root in the lumbar spine. Sciatica, which is medically known as lumbar radiculopathy, is nerve pain that originates deep in the buttock and travels down to the thigh and/or leg. The success rates of epidural steroid injections for the treatment of a few common conditions are discussed below. The treatment may also be more effective in treating acute pain (versus chronic symptoms). Other factors that may affect the outcome of this treatment include the physician’s skill and experience in administering the injection, the use of guided fluoroscopy, and the patient’s general health. The injection may sometimes be used in combination with a comprehensive rehabilitation program to increase the likelihood of longer-term pain relief and return to everyday activities. Water-soluble or non-particulate steroids, such as dexamethasone, are considered safer than particulate steroids but tend to have a short-term effect. Poorly soluble or particulate steroids, such as methylprednisolone or triamcinolone, have a long duration of action.
Research indicates that the transforaminal and interlaminar routes may obtain more effective results compared to the caudal route. 1, 5 While the injection may also be used to treat non-radicular, localized back pain, the efficacy may be low. This injection treatment is usually more effective in managing lower back pain with radiating leg pain or sciatica versus lower back pain alone. The efficacy of an epidural depends on many factors, including but not limited to: Common Factors that May Affect the Success of the Injection 3, 4 The effects of the injection may be short-term, such as a week, or may continue for a year. While some patients experience significant pain relief, 1, 2 others may not experience any pain relief from this procedure. The success rates of epidural steroid injections can vary depending on several factors.
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