The US has a chronic pain epidemic, but exercise and new techniques can long-term relief from chronic pain.
A new study published today shows a scientifically proven approach to heal chronic pain.
According to a study published in the Radiology journal by the Radiological Society of North America (RSNA), a combination of a minimally invasive procedure and epidural steroid injection treatment can provide superior pain reduction and disability improvement for sciatica patients over a one-year period. The researchers discovered that the combined treatment outperformed steroid injections alone.
Sciatica refers to the pain that originates from the sciatic nerve, which runs from the back of the pelvis down the back of the thigh. This nerve is the largest in the body, and treatments for sciatica relief typically include nonsteroidal anti-inflammatory medications, applying heat or cold, and exercising to help minimize inflammation. When a lumbar disc herniation causes pain, surgery is often recommended as the best option for relief.
“The goal of nonoperative care is to provide the most effective means of symptom resolution, while still avoiding the need for a surgical procedure,” remarks lead author Alessandro Napoli. “However, in many cases conventional approaches are ineffective.”
Interventional therapy with minimal invasion has become increasingly popular for patients with sciatica who have failed to respond to conservative treatments. Transforaminal epidural steroid injection (TFESI) is the only recommended interventional procedure in clinical guidelines. However, the benefits of TFESI are often short-lived, and additional treatments may be required.
Pulsed radiofrequency is another treatment option that researchers have explored for relieving sciatica pain. It is a minimally invasive procedure that involves delivering pulses of energy from a probe directly to the nerve roots near the spine.
In a multicenter randomized trial, researchers sought to compare the effectiveness of pulsed radiofrequency combined with TFESI to that of steroid injection alone for treating sciatica pain that lasted for 12 or more weeks and did not respond to conservative treatment in patients with lumbar disc herniation.
In the study, a total of 351 participants with sciatica, including 223 men, were randomly assigned to receive either a single CT-guided pulsed radiofrequency treatment combined with TFESI (174 patients) or TFESI alone (177 patients). The participants were recruited from two tertiary university hospitals and one spine clinic, and all procedures were carried out in an outpatient clinic. The procedures were performed without general anesthesia and took only 10 minutes.
The results showed that at four, 12, and 52 weeks, the group that received pulsed radiofrequency combined with TFESI had a greater reduction in leg pain and greater improvement in disability compared to the group that received only the steroid injection.
The findings show “that a combined treatment of pulsed radiofrequency and TFESI leads to better outcomes at one year following a single 10-minute procedure,” adds Dr. Napoli.
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