Bilateral Sciatic Nerve Block


Welcome to health care at home In our previous episode we were talking about Sciatica pain As i told you earlier that if you are suffering from Sciatica pain , you have to take hot compress. The compress i am telling you is Hot Cold compress. Hot compress sooth the tensed nerves cold compress sooth the swelled nerves. Take a bucket of water water put rock slt in it and prepare this bucket. And take normal water in second bucket take 2 towels Dip the towel with the hot water and squeeze it now put the towel to the problem area cover it.

till the time you keep feel the warmth , let the towel be on your body. Now dip the towel in to cold water squeeze it then put it on the problem area. do this remedy for half n hour and within this time you will get relief. Don't take the cold compress if you have circulatory problem. Along with this let me tell you a remedy. whenever you take milk put 810 chopped garlic cloves. put them at the time of heating the milk then consume it. and you will notice that you will get relief in sciatica pain Along with this taking proper nap is necessary as in with proper nap your muscles sooth your sciatica nerve will be relaxed.

make sure that you sleep in dark, means there should be no artificial lights in the room. if you will sleep in the dark room then too your sciatica pain will be relieved. Let me tell you a oil, take 1 cup sesame oil add 3 big spoon of nutmeg powder. and heat it nicely on the low flame after heating up, once its Luke warm then massage it with this oil. Massage with this oil on the problem area and you will be relived. Now, let us talk about what to eaté Eat lots of banana Eat Spinach, Green Peas Dry fruits

Taking honey lemon juice is also very helpful in sciatica pain. What you have to do is Take 1 glass water, put 2 spoon honey squeeze a lemon in it . Use this water 2 times in a day as its very helpful in sciatica pain. Along with this take 250gm of Parijat leaves . put them into 1 litre water and boil them thoroughly when the water is reduces to 34 or 750 ml then then strain the water and keep it into glass bottle add a pinch of saffron and mix it nicely.

Now take 11 cup of this water in morning evening. you will be relived from the sciatica pain. Acupuncture woks well in sciatica pain. if you will take acupuncture treatment from any good acupuncturist. then you will get maximum relief in the sciatica pain. Let me tell you another remedy, Take 150 gm of Carrot potato . wash , peel them and take their juice. this will be almost 1 glass of juice. Now take this juice in the morning. Do this remedy for 2 months you will get relief in the sciatica pain.

Let me tell you an external remedy, take a handful of fenugreek seeds powder mix it in a glass of milk and cook them. cook it till the time it turns into a thick paste. Once the paste is ready then take some amount of it and apply this on the problem area after applying the paste thoroughly let it apply it for 1 hour and then wash it off as this will give you relief in the sciatica pain.

Radio Frequency Ablation Demonstration

Our next procedure is something called theright side radiofrequency ablation. We're gonna be doing RF procedure in L 3, 4, 5 onthe right side. We've gone and done conformation diagnostic block approximately two week ago. We perform medial branch block using a localanaesthetic of short duration, and we are back to repeat the procedure with long anestheticwith longer duration such as neuropin. With that conformation of the patients abilityto function, to be able to bend, twist, flex and squat was asked the day following procedurewith conformation that she approved having had the anesthetic done 24 hours prior.

At this point time we're going to pointa camera towards the fluoroscope and go head and start to show you how we position, alignour spine under fluoroscopy and then go head an do the needle positioning along with theconfirmation of the solution with contrast and local anesthetic, to show how the enhancementof the local anesthetic numbs and anesthetizes the medial branch nerve. For this portion of procedure we wanna gohead and mark the inferior sacral alar, and we do that first by using a fluoroscopic guidanceneedle position, anesthetizing the skin, and deeper tissue with quarter percent lidocaine.Once we achieved that and the patient is relatively

anesthetized in that zone. We're going headin using neurotom 15 millimetres exposed, 150 millimeter needle and angle of positiondown to that sacral alar junction. Once we sacral alar junction we'll go head anesthetizewith 2% zylocaine, and little tiny bit of contrast enhancing specifically where needleplacement is. Now we're go head inject this area with2% zylocaine and contrast enhancing the area where the target is. We'll go head placein the neurotherm ablation styled and go head and proceed with one minute at 80 degreesCelsius of targeted tissue ablation. In the meantime we go head and oblique fluoroscopetowards the right and we'll go head and

mark the skin and target at L4 and L3 mediumbranch nerve. Recalling that the L4 medium branch nerveis sitting on the L5 vertebral body and the L3 branch nerve is sitting on the L4 vertebralbody. After anesthetizing skin and subcutaneous tissue of these next two sites we'll gohead and position the needle adjacent to the superior articulated process and we do thatin the very interesting technique in the oblique fashion. We go ahead and started the IAP orintra articulated process and then angle the needles tip and edge up to the lamener borderof the end plate. By the doing so we have confirmation thatthe needle was not going to enter the neuroframen,

and we know that because of the tried theproven method by angulating the SAP curvature to the to the end plate once the target hasbeen meet there is no possible way the nerve or the actual needle enters into the neuroframen.We'll go head and continue to do our ablation on the L5 S1; we will position our next needleon the L4 vertebral body, which is consistent with the L3 medium branch nerve. Please recallthat the nomenclature changes one level per segment and you have to remember this in thedictation or you will have a large mistake and misbelief of where your target is. So we'll do a second ablation now, we'llturn the needle slightly down in order to

position it slightly more into the alar grooveand go head ablate it for additional 40 seconds. If we continue to do this in al conditionsat this patient suffers with is very common and typical lumbar spondylosis, physical examhelps to confirm that by doing extension, rotation and palpating the area over facetloading. Recall the facet loading can also give youa referred pattern of pain to the bottom, gluteal area and outer aspect of the leg,but does not typically create a sciatica like the pain that descends down the L4 or L5 orS1 distribution. Remember there is very little neurological weakness or deficits found withfacet pain and usually the reflexes are found

Lumbar Spine Selective Nerve Root Block Injection pain management movies

You will be lying on your front. Your skinwill be cleaned. A small needle will be used to inject some local anesthetic to numb theskin. This may sting for a couple of seconds. The tip of a needle will be placed next tothe spinal nerve. Fluoroscopy, an XRay TV, is often used to guide the needle to the correctlocation. Some contrast dye may be injected to check the exact position of the needletip using fluoroscopy. Then the medication will be injected around the spinal nerve,the needle removed and a small bandage placed on the skin.

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