Lumbar Steroid Injection for Low Back Pain

Fitness Expert Mackie Shilstone’s sciatica flared up after training Serena Williams for the U.S. Open. He turned to the Culicchia Spine Team for relief, including Dr. Stephen Rynick, for a lumbar epidural steroid injection. He wrote about his treatment in his weekly column on nola.com.  “My pain, originating on the left outer hip then migrating to the mid-thigh and lateral calf, followed this exact path and was originally thought to be a hip bursitis — the product of the plyometric jumping we did to increase Williams’ acceleration to the ball,” he wrote.

“While I was offered several … options, I chose to maintain my extensive core exercise program and chiropractic treatments — also opting to have the lumbar spinal injections — guided by a skilled physical medicine and rehabilitative specialist, Stephen Rynick, a physician at the Culicchia Neurological Clinic in Marrero.”

Transforaminal lumbar epidural steroid injections, Rynick said, “involve advancing a needle with X-ray guidance to the foramen where the nerve root exits from the spine. Cortisone is then injected with dilute numbing medicine.”

Rynick noted in the article that “the initial disability (associated with sciatic nerve pain) can be intense, but less than 10 percent will go on to surgery” after the appropriate number of injections is performed.

The injections, Rynick said, “can be done on one occasion, if pain is completely relieved. More commonly, they are performed twice, with two to three weeks between. Typically, two injections provide more complete and longer lasting relief — with injections combined with medication, specific exercise and guided activity modification.”

“They made a big difference for me,” Shilstone wrote.