Sciatica is merely a symptom of a problem—of something compressing or irritating the nerve roots that comprise the sciatic nerve—rather than an actual medical diagnosis or medical disorder. This is an important distinction because it is the underlying diagnosis that often needs to be treated so that sciatic nerve pain can be eliminated. Common causes of sciatica are spinal stenosis, degenerative disc disease, lumbar herniated disc or spondylolisthesis. Sciatica occurs most frequently in people between 30 and 50 years of age. Most often a particular event or injury does not cause sciatica. Sciatica tends to develop as a result of usual wear and tear on of the lower spine and its structures.
The needle is smaller in size than that used during a conventional epidural approach. The procedure is performed with the patient lying on their belly using fluoroscopic (real-time x-ray) guidance, which helps to prevent damage to the nerve root. A radiopaque dye is injected to enhance the fluoroscopic images and to confirm that the needle is properly placed (See Figure 2). This technique allows the glucocorticoid medicine to be placed closer to the irritated nerve root than using conventional interlaminar epidural approach. The exposure to radiation is minimal.