During the first 4 weeks the treatment is conservative including rest, anti-inflammatory medications, pain medications and muscle relaxants. Physical therapy and home exercises also are instituted as tolerated.Then after this period if the pain and symptoms are ineffective, epidural steroid injections are indicated.
The patient lies on a special table and after appropriate intravenous sedation is administered, the skin and deeper tissues are numbed up with a dentist needle and local anesthetic.
Then a needle is advanced under x-ray guidance (fluoroscopy) til reaches the epidural space in the vicinity of the nerve. Dye contrast is then injected to confirm proper placement in the exact area of the nerve inflamed and a steroid medication is injected which act as a potent anti-inflammatory medication. This will result in resolution of the inflammation and swelling of the nerve.
The patient is observed for about half an hour in the recovery room, where vital signs are monitored, and then is discharged home. Dr. Sammarone recommends that if you have soreness or discomfort at the injection site, you can place a cold pack over the site for fifteen minutes every two hours for the first twelve hours.
Then, after 24 hours, it is recommended to use a heating pad or to take a hot shower, allowing the water to be directed on the sore area.