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James Ruport, a physical therapist and Troutdale's leading sciatica specialist, answers the question, 'Do I need an injection?'

JAMES RUPORTIn the pervious installment, I talked about pain medication with back pain and sciatica. A very brief reminder of my stance, is that I respect your decision on pain meds.

Most people want to get off of their pain meds and the medications do not solve the problem. And with poor posturing and positioning while taking pain meds, you can actually make the problem worse. But if used with therapy, they can help ease the pain as we solve the underlying problem.

After people have tried pain meds and not gotten the results they want, the next common treatment is injections. Most often, this involves injecting an anti-inflammatory steroid around the disk to minimize the inflammation and pain.

This, just like other anti-inflammatory medications might be enough to decrease the pain and get you back to function, but many other people will be stuck with the same problem, or can even get worse if they do not change the behaviors that got them injured in the first place.

Again, I respect people's decisions and help them bridge the gap to pain-free activity. I am not sure if an injection is ever needed. Our body can heal and decrease inflammation with the right care, but it can speed up the process and provide quicker relief. injections will work best when being coupled with corrective therapy.

Whether or not you get an injection, we will still go through the same process, find positions that provide relief so you can finally rest, strengthen the hips and core to minimize irritation, and correct your structure so the problem doesn't come back ever again.

To recap, I want to highlight a few points:

• For best results with an injection you should be starting to work with a rehab specialist during, if not before, the injection.

• The injection itself will rarely solve the problem on its own, and many people will get multiple injections over the years because they have not solved the underlying problem.

• Looking for pain relief is usually the tip of the iceberg. We need to get your body moving correctly to prevent this or any problem from coming back.

James Ruport is a doctor of physical therapy and is happy to answer questions you have about sciatica or his new Digital PT program, send him an email at This email address is being protected from spambots. You need JavaScript enabled to view it. or visit his website for a free copy of his eBook on back pain and sciatica.

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