Expert: Dr Ian Jackson - please note UK based - 1/19/2010

Question
Dear Dr Jackson, I am due to start a course of epidural injections for pain of the lower back caused by degenerative joint disease: spondylosis of the lumbar spine, facet joint hypertrophy, ligamentum flavum hypertrophy, posterior disc bulges with spinal stenosis,constriction of various foramina and nerve root compression. I picked up these terms when the results of the MRI scan came through. I have been advised by a friend, an anaesthetist in Italy to enquire about Misotherapy. Can you please tell me if the epidural injections will be infiltration or misotherapy? In the case of an epidural infiltration technique, can you clarify for me which drugs will be used? If steroids, can you please give me the medical and layman's names for them and regarding anti-inflammatory drugs, could you please tell me what is commonly used? Is Misotherapy in use in the UK for osteoarthritic back pain? Which of the two methods is less invasive, more likely to have an effect and subject to fewer risks? Thank you for your help.

Answer
Margaret
This is way out of my area of expertise. I haven't done chronic pain for over 21 years and so I cannot with any confidence answer these questions. My advice is to write these to your chronic pain specialist and ask him/her for clarification.
Misotherapy doesn't mean anything to me I'm afraid.
Sorry
Dr Ian Jackson