What is a Sciatica Injection?

A sciatica injection is administered to treat pain and inflammation caused by a pinched nerve in the lower back. This condition, called sciatica, causes pain that begins in the lower back and radiates down one or both legs. The pain of sciatica can be intense enough to impair day-to-day function and mobility.

The medical community has discovered that steroidal injections to treat a pinched nerve can be effective in many patients. A sciatica injection invariably consists of a steroid combined with another fluid. Such a fluid might be normal saline solution, or it might be a local anesthetic. The steroid is given to bring down the inflammation that causes sciatica. The anesthetic provides immediate pain relief to make the patient comfortable and to enable her to carry out her activities of daily living.

Some common steroids used in a sciatica injection include methylprednisolone acetate, dexamethasone, and triamcinolone acetonide. These steroids, called corticosteroids, are similar to naturally occurring compounds that the adrenal gland produces in part to combat excessive inflammatory response associated with normal body function. Natural corticosteroids are only produced in very small amounts each day, so they are insufficient to lower inflammation associated with injury or disease. Injectable corticosteroids act directly on the area of the spine that is inflamed, and they are more efficient and have fewer side effects than oral medications of the same class.

The most commonly used local anesthetics are lidocaine and bupivacaine. Lidocaine, though a popular choice, is fast-acting. Some practitioners use longer-lasting bupivacaine. Either one of these anesthetics works very well to provide fast relief in a sciatica injection. They also help to flush the area free of the pain-causing chemicals that the body sends as an immune response to the injury.

The general effectiveness of a sciatica injection for all patients has not been thoroughly researched. Relief occurs often enough for many patients to request this treatment, though in some cases the effect of the injection might not last long enough. Most of the research that has been done indicates that most patients find adequate relief.

A technique called fluoroscopy helps to ensure that the sciatica injection is placed accurately to maximize its effectiveness. The medication is injected into the epidural area surrounding the spine, hence the term “epidural injection.” The patient may have a sciatica injection up to three times a year if the treatment helps. The injections enable a patient to be active, which is important to long-term sciatica relief.