Mr G was referred with chronic musculoskeletal back pain which had troubled his for years. He had new onset leg pain with irritation of one of the nerve roots supplying his leg, thus causing severe sciatica. He had struggled with flare ups of back pain for years, affecting his sleep and mood and ability to work and exercise. More recently his sciatica had left him unable to walk other than for very short distances and only in great pain. Mr G was seen in clinic.

His medications were altered to ensure that he had pain relief going forward and a discussion about holistic methods of rehabilitation to help him with mood, sleep, mobility and function as well as the management of flare ups was discussed. A patient centred decision was made to access pain psychology and physio to help with the knock o consequences of his back pain. Mr G was also consented for an epidural to reduce the impact of his leg pain and facilitate his wider rehabilitation goals.

This was performed as a day case procedure with x ray guidance and local anaesthetic. Mr G was able to eat and drink as normal before and after the procedure. As a result of this his leg pain improved and then though his work with the medial physiotherapy and psychology teams, both his pain and function improved. He was able to walk further, manage flare ups more effectively and sleep better. He was then able to reduce some of his medication which improved his memory and enjoyment of life more generally.