Ratification Date: 16/04/2019

Next Review Date: 15/04/2022

Steroidal Epidural Injections for patients with acute & Severe Sciatica

Threshold

 

IMPORTANT NOTICE: For the foreseeable future, the NNUH will NOT be accepting referrals for Ultrasound Guided Steroid Injections

 

Norfolk and Waveney Integrated Care Board (ICB) will fund steroidal epidural injections for acute and severe sciatica with or without the presence of low back pain on a restricted basis for patients who meet ALL the following criteria:

  • patients undergo an appropriate multidisciplinary biopsychosocial assessment in MDT clinic
  • patients are permitted a single epidural steroid injection
  • If there is documented evidence of functional improvement lasting > 3 months this can be repeated at consultant discretion and at intervals of no less than 6 months.

NB: if efficacy of epidurals decline, then this management strategy should be curtailed in these patients

NICE have provided a link to United Kingdom Spine Society Board website for further detailed information on pathways that can be assessed by relevant groups for local implementation – https://www.ukssb.com/improving-spinal-care-project

 

Cases for Individual Funding Consideration (Patients who do not meet the policy criteria)

On a case to case basis, patients might be eligible for surgical intervention, in consideration of their exceptionality. The requesting clinician must provide information to support the case for being considered an exception, by submitting an individual funding request.

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