This is a special kind of targeted epidural injection to the spine designed to treat your sciatica or leg pain and give further diagnostic information to Mr Fagan.
It can also be used to treat spinal stenosis and back pain.
Mr Fagan performs all his injections personally under local anaesthetic.
In his experience sedation is not necessary if a properly done, quick and confident injection can be made.
Most patients are pleasantly surprised how quick and pain-free it is.
This includes a significant number of dentists who feel it compares favourably to a visit to the dentist's chair!
Plenty of local anaesthetic is used.
A very thin needle less than 1mm in diameter is used to approach the nerve root as it exits the spinal canal.
X-ray guidance is used to judge perfect positioning.
The needle does not penetrate the mid-line structures of the spine because the angle of approach is different.
It is this that makes traditional epidural injections more uncomfortable.
Sometimes women have experience of epidurals in labour and childbirth.
Again these are more uncomfortable because a larger needle is used in a mid-line approach.
A small volume of steroid (40mg Kenalog) and long acting local anaesthetic (0.25% Chirocaine) is injected to soothe the nerve roots.
You may notice an immediate improvement in your sciatic pain, which will hopefully last until you come back to see Mr Fagan in six weeks.
If the symptoms return in the meantime, you may need further treatment.
Very rarely (5%) people experience a so called "steroid flare" whereby the symptoms get worse before they get better.
If this happens, do not worry. Nothing is wrong, sit tight with extra painkillers and you will get a good result.
Mr Fagan has performed thousands of these with successful treatment of patients suffering with sciatica and spinal stenosis.