PAIN-RADICULAR PAIN MANAGEMENT

SUMMARY

Set the expectations for the patient: all the following procedures provide temporary pain relief!

1. Caudal epidural steroid injections: suitable for central canal stenosis and in cases where multiple dermatomes are involved.

2. Selective nerve root blocks: for single level or few levels.

3. Pulsed radiofrequency blocks for radiculopathy.

4. Neuromodulation: when the patient is unresponsive to the above, persistent low back or leg pain, failed back syndrome (FBSS). Best indication for FBSS.

NB: note that these are diagnostic as well as therapeutic procedures. Temporary response to the above-mentioned procedures can be a good prognostic factor for surgical intervention.

Reference(s)

Cifu, D.X. (2020). Braddom’s physical medicine and rehabilitation. Elsevier. Get it on Amazon.
Cuccurullo, S. (2019). Physical medicine and rehabilitation board review. New York: Demosmedical. Get it on Amazon.
O’Young, B., Young, M.A. and Stiens, S.A. (2008). Physical Medicine and Rehabilitation Secrets. Mosby. Get it on Amazon.