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Hi again. I am 68 years old male with Sciatica

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Posted on Mon, 25 Mar 2019
Question: Hi again. I am 68 years old male with Sciatica. I am having EMG/NCS test tomorrow. For my Sciatica, I use daily lidocaine patch on the butt and lidocaine cream plus voltaren gel on the hamstring and calf. My test is at 3 pm tomorrow. Is it ok to do the lidocaine/voltaren stuff tomorrow morning ? If not, can I take 1 Aleve in the morning. If it is best not to take anything, let me know. Thanks for your prompt response.
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Answered by Dr. Olsi Taka (9 hours later)
Brief Answer:
You can take Aleve, avoid the cream and gel.

Detailed Answer:
Hello and thank you for coming to HealthcareMagic.

I read your question only now, hope I'm not answering too late.
The lidocaine patch in the gluteal region should be fine, but the cream and gel should not be used. You can take Aleve safely it doesn't interfere with the test results.

I hope to have been of help.
Above answer was peer-reviewed by : Dr. Nagamani Ng
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Follow up: Dr. Olsi Taka (35 hours later)
Thank you for your response. I got it in time.

The EMG/NCS test was done by a neurologist. He said that L5 is the problem and recommended injecting it. What are your thoughts about it? Risk vs epidural injections, any other risk, chance of success etc.

Thanks.
doctor
Answered by Dr. Olsi Taka (46 minutes later)
Brief Answer:
Read below.

Detailed Answer:
Hello again!

A selective nerve block does offer a more selective treatment than epidural shot. Has a little higher success rate than epidural shots, figures vary in literature, from 40-70 % success rate reports. It has similar risk of infection and bleeding as the epidural shots and a slightly higher risk of damaging the nerve root (but usually reversible damage). It does take more expertise in performing it than an epidural shot even under xray guidance.

Whether I would advise it, rarely. It is a temporary measure, its effect lasting 2-3 months on average, it is not a long term solution. So it is something I recommend only when the patient is under very intense pain not improved by pain medication (anti-inflammatory pain killers and medication for neuropathic pain). In that case when there is intense pain, in particular limiting movement, I recommend injections (whether epidural or nerve blocks) as an attempt to temporarily alleviate the pain an enable the patient to continue with physical therapy, the one intervention with proven long term benefit.
Otherwise if the pain is manageable with medication I wouldn't go for it, as I said even if effective it would be temporary, the long term outcome is the same with or without it.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Olsi Taka

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Practicing since :2004

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Hi again. I am 68 years old male with Sciatica

Brief Answer: You can take Aleve, avoid the cream and gel. Detailed Answer: Hello and thank you for coming to HealthcareMagic. I read your question only now, hope I'm not answering too late. The lidocaine patch in the gluteal region should be fine, but the cream and gel should not be used. You can take Aleve safely it doesn't interfere with the test results. I hope to have been of help.