Sciatic Nerve Pain - "When is it Time for an Injection?"

When it comes to sciatic nerve pain (aka "sciatica"), our goal is always to help people avoid injections and surgery, as well as pain medications.
However, there are times and situations when having an injection is the best option for more lasting pain relief. This is especially true for specific types of nerve root compression.
In this video, I'm going to share my Mom's situation with you: she's an active woman in her late 60's who's having classic nerve-root-impingement sciatic nerve pain.
She's made good progress with her conservative treatments, which include physical therapy, massage therapy and using an inversion table, but she's basically reached a plateau.
At this point, considering an injection is a good option to help her relieve her pain and get back to walking 3-4 miles/day.
I'll make several key points as I tell her story to help you figure out if having an injection for your sciatic nerve pain is your best option.
Leave my Mom a positive comment before you go!
- Luke Gordon, DPT
Doctor of Physical Therapy/Owner of Gordon Physical Therapy
www.GordonPhys...

[@Macjohn1419]

I’m in the same situation. I still work but at the moment I’m on short term disability. I was using a chiropractor and physical therapy. I since stopped the chiropractor as it wasn’t adding to or enhancing the recovery. It’s a slow process and I am going through the roller coaster, as well. The therapists are very young and tend to be aggressive with the exercises, which in turn makes me regress in my treatment. I had to cancel several treatments because I needed my back to recover. I visited my physician and he put me on an aggressive tapered prednisone treatment. It helped tremendously to reduce the inflammation and pain. Now I can continue my exercises to strengthen my back and core muscles. Hopefully I get to point that I don’t require an MRI or pain management injections. As for the therapists, I continue to work with them, however, I let them know that I do certain exercises as tolerated. I’m not 22 anymore.

[@lindasaunders7487]

What a timely video, this morning i am having a sciatica attack, Ive recenty had knee replacement surgery on the other side, trying to keep up with exercises etc. Im a lady in her late 60s too, i send your Mom my best wishes. Thank you .

[@GordonPhysicalTherapy]

Thank you, Linda! Don't hesitate to get help for your sciatic nerve pain. It can really slow you down if you try to wait it out!

[@richardpoland4074]

What kind of injections are you referring to? ESI's or PRP? Have bursitis in hip and swelling in L5. PT has helped. Had achy sore pain in groin, down front and back of leg, hip and back and butt. Few months ago, every step hurt but PT helped. Pain going down leg premuch controlled but pain still in groin, hip back and butt. Continuing with PT to manage it and hope don't need injections. Thought it was sciatica but PT had me do couple stretches and she said I would've jump off table if sciatica which I didn't. She's thinking it's muscle pain, i.e. tightness versus nerve pain.

[@salehmir9205]

Thank you for the video. PLEASE HELP ME! I've been dealing with sciatic pain for over four years now. It started basically around the time of the pandemic. Because I couldn't get proper treatment at the time, it kind of stayed with me and got worse. Now the recovery is very slow. I've tried everything except injection and surgery. The doctors say that it's a very mild case of disc slippage on my L5 and L4, and there is no way they're going to do surgery on me. I've tried acupuncture, physical therapy, medications, chiropractic lots of other things for YEARS, and everything works except only temporarily. The best thing that has worked for me has been progressive exercises. But the problem is the recovery phase is very slow. For example, I've been doing them non-stop for the past six months, and while I have seen improvements, I'm pretty sure I'm gonna have these limitations for at least another six months or so. Limitations such as not being able to sit pain-free and not being able to sit for more than, let's say, 20 minutes at all. If I sit longer, then I'm gonna have to pay for it, and this is affecting my relationship. At this point I don't remember how being normal feels like any more. when the doctors see my MRI they treat me as if I'm normal and nothing is wrong with me and they don't take me seriously. one of the most even put me on antidepressant drugs saying that it might be mental but that didn't help either. Do you think if I take an injection now it would help?

[@stevedonnatvcanada3480]

Thanks for this video. I have all these symptoms. Sharp pain - down back of butt - leg - calf and into foot. Can barely walk. Severe pain. I’m 57 yr old male. I’m n ns Canada. I have gone through a year of PT. Only getting worse. Ct scan shows ddd - spondo More bad news the wait time for injections - 3 yrs here!!!! I’m lucky I’m only have to wait 6 mths 😢. I hope it works

[@chrisandkrisholiday3961]

thank you for the very informative video. You mention injections, is this an epidural or trigger point injections or something other than those?

[@GordonPhysicalTherapy]

Thank you! I was referring to epidural injections.

[@jeniperillo-natural-vanity]

Hey there, thank you so much for posting this. I would like to know how she’s doing what did she decide? The course of treatment will be? If she has received a shot how is it been working?

[@GordonPhysicalTherapy]

I'm glad to asked! As it turns out, my Mom decided to try the "20-30 Fast Track" program, which is a super clean and structured 30-day diet. It's basically an elimination diet: we take away all grains, dairy, legumes, etc. and we focus on lean meats, veggies and fruits. This program worked amazingly well for my Mom! She started having improvements in her nerve pain after the first couple weeks, and now, several months later, she's able to walk 1.5-2.0 miles at a time, and her nerve pain is significantly better. Plus, she's lost over 30# total! Doing a "diet" was the last resort for my Mom, and she's been able to avoid injections. It was pretty cool!

[@jeniperillo-natural-vanity]

wow! I’m so happy for her 🏆 what a warrior. She must feel so amazing to be able to do this naturally AND to lose 30 pounds. That probably helps to relieve pressure. This is great. I actually received the procedure in the video about 20 minutes after watching ….so it’s only been a few hours at this point. I can report back the progress, I'm hopeful. I don’t feel much of a difference just yet. ☹️🎉 Caudal Equina Syndrome, For the last nine years for me L5/ S1 I cannot live like this anymore.

[@punanamousme8486]

My Sciatica started two months ago. Constant pain down my right leg and under my foot. Bottom of foot feels like a brick. MRI says 2 bulging disks. I'm over the constant pain. Scheduling the steroid injection today.

[@GordonPhysicalTherapy]

I'm sorry to hear that! I hope the injection helps. Has anything else helped to relieve the pain, such as traction or inversion?

[@zoha-mj6xo]

Sir please tell can ear mri detect the reason of vertigo and head and neck mri Detect the reason of head pain and vertigo please tell

[@GordonPhysicalTherapy]

No, an MRI won't detect inner ear vertigo, unless it's caused by something structural in your brain. It won't help with diagnosing BPPV. A neck MRI won't help diagnose cervicogenic vertigo either.