So I saw a patient who had a traumatic disruption, which could be an annular tear, or a tear to the disk and causes a bulge or herniation to the disk, the patient it started in conservative treatment, physical therapy, using oral medications, which include anti-inflammatories. muscle relaxants, medications that help with nerve pain such as Neurontin. This patient continued to have symptoms in their back and in their leg produced from this disk disruption. The patient continued to have symptoms and we elected after long discussion to undergo what we call an epidural steroid injection.
An epidural steroid injection is the introduction of through a small needle under an x ray machine of a medication called of cortical steroid. A cortical steroid helps decrease inflammation, information around the disk, information to the nerve. The patient underwent two injections over the course of six weeks at the L4, L5 segment, and today seeing the patient, the patient had significant reduction and their leg and their back pain. They work construction and they’re able to go back to work in construction. They use anti-inflammatory medicine as needed for flare up and overall have seen significant improvement from the epidural steroid injection.
In this particular case, this patient, I’ll see back in three or four weeks to make sure they’re continuing to have benefit and that they don’t need any further treatment. Otherwise this patient would be a successful epidural steroid injection for all of the reasons we would do it for back pain and leg pain.
So when we talked about a traumatic disruption, this could be from lifting, lifting and twisting, could be as simple as a sneeze. We see it commonly with falls. I see patients like this in motor vehicle accidents commonly, so trauma that goes through the spine. From as much as a freeway crash to as simple as picking up a pot. So I think we see all kinds of people. We see patients as obviously the age, the disk becomes less healthy, less pliable, and so a car accident, a fall, picking up a pot, a sneeze can actually cause damage or trauma to the disk and cause a herniation causing back pain, back pain and leg pain.