Best way to relieve chronic pain of sciatica revealed

By Stephen Beech SWNS

Zapping nerve roots near the spine with an energy pulse for 10 minutes is the best way to relieve the chronic pain of sciatica, according to a new study.

Researchers discovered that the "minimally invasive" procedure that doesn't require anesthetic combined with an epidural steroid injection led to better pain reduction and improved movement over 12 months.

The combined treatment performed better than steroid injections alone, according to the findings published in the journal Radiology.

Sciatica is pain that originates along the sciatic nerve, the largest nerve in the body, which extends from the back of the pelvis down the back of the thigh.

It usually affects one side, starting from the lower back or bottom and spreading down one leg.

Symptoms of sciatica include shooting pain that starts in the lower back or bottom and runs down the back of the leg, often to the foot and toes.

Treatments to relieve pain include nonsteroidal anti-inflammatory medications, applying heat or cold and exercising to help minimize inflammation.

When the pain is caused by a slipped disc, surgery is often the treatment option for pain relief.

Study lead author Professor Alessandro Napoli said: “The goal of non-operative care is to provide the most effective means of symptom resolution, while still avoiding the need for a surgical procedure.

“However, in many cases conventional approaches are ineffective.”

He said minimally invasive interventional therapy has become increasingly popular with sciatica patients who have become resistant to conservative treatments.

Among the available options, transforaminal epidural steroid injection (TFESI) is the only interventional procedure recommended in clinical guidelines.

However, the benefit is usually only short-term, and additional treatments are often necessary.

Another treatment that researchers have studied for sciatica pain relief is pulsed radiofrequency - a minimally invasive procedure in which pulses of energy from a probe are applied directly to nerve roots near the spine.

For the trial, researchers wanted to determine the difference in effectiveness between pulsed radiofrequency combined with TFESI and the steroid injection alone for sciatica pain lasting 12 weeks or longer and not responsive to conservative treatment in patients with a slipped disc.

A total of 351 participants with sciatica were randomly assigned to receive a single CT-guided pulsed radiofrequency treatment combined with TFESI or TFESI alone .

All procedures were carried out in an outpatient clinic, took only 10 minutes and were performed without general anaesthetic.

At four, 12, and 52 weeks there was greater leg pain reduction and greater disability improvement in participants who received pulsed radiofrequency combined with TFESI compared to the participants who only received the steroid injection.

Prof. Napoli, of Sapienza University in Italy, added: “The results of our trial demonstrate that a combined treatment of pulsed radiofrequency and TFESI leads to better outcomes at one year following a single 10-minute procedure."