Epidural Didn’t Help My Sciatica — What Should I Do Next? | San Diego, CA

You did the physical therapy. You tried the medication. Your sciatica was still there, so eventually you had an epidural steroid injection.

And either it didn't help—or it helped for a while and the pain came back.

Now what?

Dr. Cassidy James Boelk, DC sees patients in this situation regularly. Some felt almost no change after their injection. Others felt considerably better for several weeks or months, only to have the pain, burning, tingling or numbness gradually return.

That doesn't necessarily mean the injection was a mistake.

An epidural injection is generally intended to reduce inflammation around an irritated spinal nerve. For some people, that can provide substantial relief. But if a disc herniation, disc bulge or narrowing around the nerve is still contributing to the problem, the symptoms may continue or return.

After more than 22 years treating disc injuries and sciatica, Dr. Boelk wants to know something very specific when a patient tells him they've already had an epidural:

What happened afterward?

That answer can provide useful information about what's going on.

Dr. Boelk has performed more than 100,000 spinal decompression treatments. The Spinal Decompression & Chiropractic Center of San Diego has seven DRX9000 systems and is the largest known Non-Surgical Spinal Decompression clinic in Southern California.

⭐⭐⭐⭐⭐ “I Was One Step Away From Back Surgery”

“For the first time in 10 years, I am completely pain-free.”

“For the first time in 10 years, I am completely pain-free. My sciatca is gone, and I no longer have back pain.

Before finding Dr. Boelk, I tried chiropractic care, acupuncture, pain medications, and several other therapies that simply didn't work. I was one step away from back surgery when I discovered spinal decompression treatment at The Spinal Decompression & Chiropractic Center of San Diego.

The results have been incredible. Every visit was comfortable, relaxing, and completely pain-free. Dr. Boelk and Patty always took the time to explain everything and made me feel genuinely cared for throughout the process.

They are warm, welcoming, and truly dedicated to helping their patients.

Thank you, Dr. Boelk and Patty!”

— Toni H., San Diego, CA

Toni had been dealing with sciatica and back pain for years and had already tried several different forms of treatment before looking for another option.

Her story is also a good example of why Dr. Boelk doesn't assume that someone who has already tried multiple treatments is out of options.

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The Epidural Didn't Work. Before Deciding What Comes Next, Find Out Why.

If you've already tried physical therapy, medications and an epidural injection, you may be wondering whether surgery is now the next step.

Sometimes it may be.

But not automatically.

Dr. Boelk offers a No-Charge Consultation so patients can sit down with him before making that decision and find out whether he believes another non-surgical option may be appropriate.

You are not coming in because you've already decided to start spinal decompression.

You're coming in to get an experienced opinion.

During the consultation, Dr. Boelk personally will:

• Listen to how your sciatica started and how it has changed.

• Go over exactly where the pain, numbness, tingling or burning travels.

• Discuss what happened after your epidural injection.

• Ask whether you received no relief, partial relief or significant relief.

• Ask how long any improvement lasted.

• Discuss what happened during physical therapy or other treatment you've tried.

• Ask how long you can sit, stand or walk before symptoms increase.

• Discuss weakness or other neurological changes.

• Review your actual MRI images and report if available.

• Compare the MRI findings with your symptoms.

• Discuss whether additional examination or imaging may be appropriate.

• Determine whether Non-Surgical Spinal Decompression may be an option.

• Tell you if he does not believe you're an appropriate candidate.

• Answer your questions and explain what he believes makes sense next.

No MRI yet? That's okay.

There is no charge and no obligation to begin treatment.

Dr. Boelk personally performs these consultations while also caring for his existing patients throughout the week. Because of the time involved, the office can only set aside a limited number of No-Charge Consultation appointments in the schedule.

Once those appointments are taken, new patients are offered the next available openings.

Call 619-298-0800 and ask about the next available No-Charge Consultation with Dr. Cassidy James Boelk, DC.

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Did the Epidural Do Nothing—or Did It Help and Wear Off?

These are not necessarily the same situation.

When someone tells Dr. Boelk, “The epidural didn't work,” he usually wants more detail.

Did you feel absolutely no change?

Did your pain decrease 20 or 30 percent?

Did you feel dramatically better for two days?

Two weeks?

Two months?

Did your back pain improve while the leg pain remained?

Did the burning decrease but the numbness in your foot stay the same?

Were you suddenly able to walk farther before the symptoms started?

Those details matter.

The goal isn't to decide whether epidural injections are “good” or “bad.” It's to understand how your particular problem responded.

Why Can Sciatica Come Back After an Epidural?

Sciatica is a symptom involving irritation of a spinal nerve.

That irritation can occur for different reasons.

A lumbar disc may be bulging or herniated near a nerve root. The opening where a nerve exits the spine may be narrowed. Degenerative changes can reduce available space around the nerve.

Inflammation can also be part of the problem.

An epidural steroid injection is designed to reduce inflammation around the irritated nerve. If inflammation decreases, symptoms may decrease as well.

But reducing inflammation doesn't necessarily mean every underlying structural factor has changed.

That may help explain why one person gets long-lasting relief while another feels better temporarily and another notices very little change.

The next step should depend on what's actually happening in your case.

What Does Your MRI Show?

If you've already progressed to an epidural injection, there's a good chance you've had an MRI.

Bring it.

And whenever possible, bring the actual images—not just the written report.

Dr. Boelk wants to see where the disc is injured, how significant the finding appears, whether there is narrowing around a nerve and whether the imaging makes sense with the symptoms you're describing.

For example, an MRI might show an L5-S1 disc problem, but Dr. Boelk still wants to know where the pain travels.

Is it in the buttock?

Back of the thigh?

Calf?

Foot?

Are there specific areas of numbness?

Is there weakness?

What happens when you sit, stand or walk?

An MRI finding becomes more useful when it correlates with what the patient is actually experiencing.

What If the Injection Helped for a Few Months?

Don't dismiss that information.

If you received substantial relief and were able to walk, sit or function better for a period of time, tell Dr. Boelk.

The fact that symptoms later returned doesn't erase what happened during those weeks or months.

On the other hand, if you've now had repeated injections with progressively shorter periods of relief, that's important too.

Dr. Boelk wants the entire history.

How you responded to previous treatment helps him decide whether another non-surgical approach is reasonable to consider.

⭐⭐⭐⭐⭐ “I Could Get Back to Surf, Jiu Jitsu and Work”

“I tried many different non invasive treatments, pain killers but relief was just temporary.”

“When I first came here I was suffering from sciatica pain for several months non stop. I tried many different non invasive treatments, pain killers but relief was just temporary. I heard about Dr. Boelk on social media and after reading other people testimonials about him I decided to try. It felt better since my first session. After 12 I felt I was improving a lot but still had room to get better so we decided trying 12 more. After 36 sessions I felt I was back to normal. I could get back to surf, jiu jitsu and work after 6 months away. Doctor helped me through the whole process, leaving me free to decide the next step and being honest about expectations. I totally recommend for all my friends that suffer from sciatica pain. It’s worth 100%.”

— Yuri Fresia

Yuri's sciatica had kept him away from surfing, jiu jitsu and work for six months. He had already tried other non-invasive treatment and pain medication before coming to the office.

One part of his review that reflects Dr. Boelk's approach particularly well is that he felt free to decide the next step while Dr. Boelk remained honest about expectations.

Could Non-Surgical Spinal Decompression Be an Option After an Epidural?

For an appropriate patient, it may be worth evaluating.

Dr. Boelk commonly evaluates patients with:

• Lumbar disc bulges.

• Lumbar disc herniations.

• L4-L5 and L5-S1 disc injuries.

• Degenerative disc disease.

• Disc-related sciatica.

• Foraminal narrowing.

• Selected cases of spinal stenosis.

The clinic uses the DRX9000 exclusively for Non-Surgical Spinal Decompression.

But an unsuccessful epidural injection does not automatically mean spinal decompression is the next treatment.

Dr. Boelk still needs to determine whether you're an appropriate candidate.

He considers your symptoms, neurological findings, imaging when available, spinal stability, bone health, previous surgery and response to prior treatment.

How Much Has the Sciatica Changed Your Life?

Sometimes the most important question isn't whether your pain today is a 5 or a 7.

It's what you're no longer doing because of it.

Six months ago you could walk for 30 minutes. Now it's 10.

You stopped going to the gym.

You're avoiding golf.

You don't want to sit through a flight.

You plan errands around how long you think you can stand.

You stopped taking your normal evening walk.

Maybe you're sleeping in a different room because you can't get comfortable.

Patients often adapt gradually to sciatica and don't realize how much they've given up until someone starts asking specific questions.

That's why Dr. Boelk pays attention to function as well as pain.

If the injection didn't provide the improvement you hoped for, look at where you are compared with three or six months ago.

Are you getting your life back?

Or are you gradually doing less?

Does an Unsuccessful Epidural Mean You Need Surgery?

No. Not by itself.

There isn't one automatic sequence where physical therapy fails, then an injection fails, and surgery must come next.

The decision depends on the diagnosis, severity of symptoms, neurological findings, imaging, stability of the spine, previous treatment and how much the problem is affecting your life.

There are also situations where delaying surgical or urgent medical evaluation would not be appropriate.

Rapidly progressing weakness, significant neurological loss, new bowel or bladder dysfunction, difficulty initiating or controlling urination, or numbness involving the groin, inner thighs or saddle region requires prompt medical evaluation.

Dr. Boelk does not believe avoiding surgery should become more important than making the right decision for the patient.

★ Not Every Patient Is Accepted for Spinal Decompression

“We both determined that surgery was my only option to correct my back issues.”

“I found this terrific practice on social media. I followed up and did my own research so I decided to pay them a visit. The place is clean, well organized and run by a very efficient receptionist. I met with the doctor and after a honest and forthright conversation, we both determined that surgery was my only option to correct my back issues. I will return as a customer when the time is right.”

— Jeff J., Tucson, AZ

Jeff came to Dr. Boelk looking for another option. After an honest evaluation, they determined surgery was the appropriate direction for his condition.

That's an important reason the consultation comes before treatment.

The goal isn't to find a reason to put every patient on the DRX9000.

It's to determine whether the treatment actually makes sense.

More Than 22 Years Focused on Non-Surgical Spinal Decompression

Dr. Cassidy James Boelk, DC has more than 22 years of experience with Non-Surgical Spinal Decompression and has performed more than 100,000 spinal decompression treatments.

His professional background includes:

• Doctor of Chiropractic

• Certified Spinal Decompression Doctor

• Certified Pain-Free Performance Specialist (PPSC)

• Founder, Non-Surgical Spinal Decompression Training Academy

• Trains other doctors in spinal decompression protocols and techniques

• Founding Member, American Spinal Decompression Society

• Member, International Disc Education Association

• California X-Ray Radiation Supervisor & Operator

Dr. Boelk also understands spinal injury personally. He suffered an L5 compression fracture at age 16 and later dealt with disc injuries and sciatica himself.

Your Epidural Didn't Give You the Result You Wanted. Find Out What Makes Sense Next.

If your epidural didn't help—or the relief didn't last—you don't necessarily need to keep repeating the same treatment.

And you shouldn't assume spinal decompression is automatically the answer.

Get another look at the problem.

Bring your MRI images and report if you have them. Tell Dr. Boelk exactly what happened after the injection, how long any relief lasted and what you're still unable to do.

Then find out whether he believes another non-surgical option makes sense.

The consultation is personally performed by Dr. Boelk. There is no charge and no obligation to begin treatment.

Because Dr. Boelk performs these consultations himself while continuing to care for his existing patients, only a limited number can be accommodated in the clinic schedule.

Call 619-298-0800 and ask about the next available No-Charge Consultation with Dr. Cassidy James Boelk, DC.

The Spinal Decompression & Chiropractic Center of San Diego
5095 Murphy Canyon Road, Suite 300
San Diego, CA 92123

619-298-0800
SanDiegoBackCare.com

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