Transforming Lives Through Health

Sometimes persistent back or leg pain continues despite previous injections, physiotherapy or even spinal surgery. In many of these patients, the problem is not simply ongoing inflammation but the formation of scar tissue (epidural fibrosis) around the spinal nerves. This scar tissue can tether or irritate the nerve, preventing medication from reaching the area effectively and allowing pain to persist. A Racz Catheter procedure, also known as Percutaneous Epidural Adhesiolysis, is a specialised technique designed to release these adhesions and deliver treatment directly to the affected nerve.

The procedure is most commonly recommended for patients with persistent sciatica, failed back surgery syndrome (FBSS), chronic lumbar nerve root pain, spinal stenosis and long-standing back or leg pain that has not responded to more conventional treatments. Following a comprehensive assessment, I will determine whether your symptoms and imaging suggest that epidural adhesions may be contributing to your pain.

The treatment is performed as a day-case procedure using continuous fluoroscopic (X-ray) guidance to ensure the highest level of precision and safety. After the skin has been numbed with local anaesthetic, a fine needle is introduced into the epidural space through the natural opening at the base of the spine, known as the sacral hiatus. A very flexible Racz catheter is then carefully advanced towards the affected spinal nerve under real-time X-ray guidance.

Once the catheter reaches the target area, contrast dye is used to confirm its position and identify areas where scar tissue may be restricting the spread of medication. Using gentle mechanical movement together with specially selected solutions, the adhesions surrounding the nerve can often be loosened or disrupted, allowing anti-inflammatory medication to reach areas that may previously have been inaccessible. The aim is to reduce inflammation, improve nerve mobility and restore a healthier environment around the affected nerve.

Most patients return home the same day after a short period of observation. Some experience an improvement within a few days, whilst for others the benefits develop gradually over several weeks as irritation around the nerve settles. As with all interventional pain procedures, results vary between individuals, but many patients notice improvements in leg pain, walking distance, mobility and overall quality of life.

A Racz Catheter procedure is not suitable for every patient with back pain, which is why careful patient selection is essential. My philosophy is always to recommend the least invasive treatment most likely to help. However, for carefully selected patients with persistent spinal nerve pain, epidural scarring or pain following spinal surgery, this advanced procedure can provide an important treatment option when other therapies have not produced lasting relief.

Every patient deserves an individual assessment rather than a standard treatment pathway. By combining careful diagnosis with advanced image-guided techniques and evidence-based practice, my aim is to identify the true source of your pain and develop a personalised treatment plan that helps you move more freely, reduce pain and regain confidence in your everyday life.