After visiting my orthopedist I have decided to have an epidural steroid injection (ESI) as the course of action I should take for now for my back and sciatica pain. ESI is the only non-surgical treatment option that allows me to function normally for the long-term. My previous one lasted nearly two years. However, it does not and cannot address the root cause of the problem.
I have a herniated or degenerative disk that is compressing the sciatic nerve that runs down my right leg. Any pain related to the compression of or damage to a sciatic nerve is called sciatica.
Before the nerve became an issue, I just had the back pain due to my disks. I was able to knock out the pain with Chiropractic treatment. The nerve pain came a little later and Chiropractic could not treat this. I could have continued but did not see the point. The primary issue was now nerve pain and the treatment could not help me in this regard. I have a great Chiropractic doctor who admitted as much, he is a rare one who will tell you when it cannot help you. I do recommend him for normal adjustments if you are in the Vienna, VA area.
Before I initially saw an orthopedist the first time I had this problem, my primary care physician prescribed physical therapy and some muscle relaxers to help with the pain.
Physical therapy was to strengthen the core muscles in order to help support the spine. I can't really say that it helped much. However it felt really good. Especially the transcutaneous electrical nerve stimulation (TENS). After massaging the back the therapists would place a TENS device with four electodes on my lower back and cover it with a heating pad. The TENS unit uses electric current to stimulate your nerves. This treatment lasted about 15-20 minutes. It felt great. But 10 minutes after I left the clinic, the nerve pain returned.
Meds are for short-term pain management and can make life easier when you are on them. But they also didn't help me much. My muscles felt really good, or not at all, but it didn't do much for the nerve pain. I did get some temporary pain relief but only used them when it was nearly unbearable. And of course you can't take these during the day without looking and feeling like you are in the Dr. Teeth and the Electric Mayhem band. So I take some Advil as it and other non-steroidal anti-inflammatory drugs (NSAIDS) do help with the inflammation around the disks.
ESI is essentially long-term pain management and an anti-inflammatory treatment. It can be effective anywhere from a few weeks to a few years and it's recommended to have not more than three injections a year. Long-term effects (good and bad) are still under study. My first one worked for nearly two years. Other than ESI, surgery is the only option I can consider. But I am very leary of that right now and do not want to be laid up for a month or so.
I will miss the last quarter of my current Uechi-ryu training session. And contrary to a certain myth regarding Uechi Kanbun (I am not affiliated, nor familiar with, the group in the link), Sanchin is not the only position/posture where I feel no pain. Sanchin is actually very painful in this condition. With ESI, you can pretty much get back to normal/exercise in a day or two if you have no complications. I look forward to that and starting the next Uechi session in January. I am bummed as I thought I may test this session, but hey, it's my back.
I'll have an update on this later next week.