Innovative Alternatives for the treatment of sciatic pain
The treatment of sciatic pain has evolved in recent years with the development of new regenerative and intradiscal techniques. These options seek not only to relieve pain, but also to promote the regeneration of the affected tissues and prevent the progression of disc damage.
Regenerative medicine in the treatment of sciatic pain
In recent years, regenerative medicine has emerged as a promising alternative in the treatment of low back and radicular pain. Among the most widely used options are:
- Platelet-rich plasma (PRP): Stimulates regeneration of damaged tissue by releasing growth factors.
- Mesenchymal stem cells: Promote intervertebral disc repair and reduce inflammation.
Epidural application of these treatments has the potential to reduce inflammation and improve nerve and disc tissue regeneration, although long-term studies are still required to determine their ultimate effectiveness.
Intradiscal techniques for the treatment of sciatic pain
Intradiscal techniques are aimed at reducing pressure on the nerve root and relieving pain caused by spinal nerve compression. They are divided into chemical techniques and physical techniques.
Chemical techniques: injections to reduce disc volume
- Intradiscal discogel injection: An ethanol-based gel that, when introduced into the intervertebral disc, reduces the pressure inside the disc and relieves compression on the nerve root.
- Advantages: Outpatient procedure, low risk and less aggression to the disc.
- Disadvantages: Not effective in bulky or calcified hernias.
- Intradiscal ozone: Injection of ozone into the disc to reduce its volume and improve oxygenation of the surrounding tissues.
- Advantages: Anti-inflammatory and analgesic effect, minimally invasive technique.
- Disadvantages: Variable results depending on the type of hernia, does not regenerate the disc.
- Intradiscal regenerative medicine: Use of PRP and stem cells to improve disc regeneration and slow disc degeneration.
- Advantages: Regenerative potential of the disc, may reduce the need for surgery.
- Disadvantages: Results still under investigation, high costs.
Physical techniques: minimally invasive procedures
- Intradiscal resadisc technique: Uses radiofrequency applied inside the disc to reduce its volume and relieve intradiscal pressure.
- Advantages: Less aggression than conventional discectomy, lower incidence of epidural fibrosis.
- Disadvantages: Not always effective in bulky hernias.
- Herniotome: Fragments and aspirates herniated material to reduce intradiscal pressure and relieve sciatica.
- Advantages: Fast procedure with short recovery.
- Disadvantages: May need to be repeated if the hernia recurs.
- Intradiscal radiofrequency: Modulates pain transmission without the need for disc resection.
- Advantages: Analgesic effect without altering the disc structure.
- Disadvantages: Does not reduce the size of the hernia.
- Intradiscal laser: Uses laser energy to vaporize part of the nucleus pulposus and reduce pressure on the nerve root.
- Advantages: Minimally invasive technique.
- Disadvantages: Risk of thermal damage to nearby tissues.
Conclusion
Advances in regenerative medicine and intradiscal techniques offer new options for patients with chronic sciatic pain. These therapies make it possible to treat the cause of the pain with less invasive procedures and with less risk than conventional surgery. The choice of treatment will depend on the type of disc pathology and specialized medical evaluation.
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Dr. Jorge Orduña Valls is a specialist in Anesthesiology, Resuscitation and Pain Management, and serves as National Medical Director of MIVI Salud, in addition to being Director of the Pain Unit at its headquarters in Valencia.
- He has more than ten years of experience in reference units both nationally and internationally.
- Among his training highlights: Doctoral thesis with Cum Laude mention in 2020 (University of Santiago de Compostela) , European Diploma in Pain Medicine (EDPM) awarded by European Pain Federation (EFIC) in 2017.
- He completed training stays in the USA (e.g. at the Millennium Pain Center in Bloomington, Illinois) and at centers in Miami, Germany and France.
- He is an expert in interventional techniques for pain: radiofrequency, rhizolysis, nerve blocks, etc.
- In research, he has published relevant papers, for example the study “The Nerve to Vastus Medialis as a Target for Treating Chronic Medial Knee Joint Pain: An Ultrasound-Based Anatomical Localization Study” in the journal Pain Medicine (2025) together with other specialists in the field.