As a doctor who treats patients with back pain and sciatica all day, lumbar epidural injections + fish oil is a great and powerful combination that I use on my own intermittent left S1 disc/nerve problem. Why do I use this combination on my own problem? First, epidural injections can be a great way to calm down an inflamed spinal nerve when the fire just gets too much to manage. I consider this like putting allot of water on a really big nerve fire. In addition, we stay away from very high dose steroids in our epidurals and have replaced the milligrams with nano-grams of steroid. This is because this is closer to the dose range that the body uses naturally. In addition, since we have our own stem cell culture lab, we add in platelet lysate or a VEGF rich supernatant from cultured platelets. What’s all that mean? These natural preparations made from the patient’s own blood platelets bring natural growth factors to bear to help the disc bulges heal themselves. Fish oil is a natural management tool for the day to day inflamed spinal nerves (sciatica) many of us get form sitting too long or just chronic bulges. Our friend Joe Maroon (a Neurosurgeon at the University of Pittsburgh) conducted a study where he was able to get about 60% of his patients off of NSAID’s like Motrin by substituting a high quality fish oil loaded with Omega 3 fatty acids. We personally use the same brand he uses, which is Nordic Naturals. Too often fish oil is made from oxidized and cheap junk fish, while these guys do the processing right. What to do when the epidurals and fish oil no longer work well? We use the patient’s own stem cells injected into the disc tears that are causing the bulges (to help heal the tears and reduce the size of the disc bulges). This method usually helps our patients avoid low back surgeries (where the disc is too often weakened by cutting off the disc bulge). Repair is better than cutting out-at least that’s what we believe at The Centeno-Schultz Clinic.