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Many patients at that point we’ll opt if they don’t have any neurologic deficits, which are weakness and numbness, then to go for what are called epidural steroid injections. Sometimes these things are called epidurals. Sometimes they’re called transforaminal injections. The needle trajectory in the spine is not so important as it is that the deposition that now you’re getting steroids right where the problem is and that’s why you don’t put the cart before the horse. You get the imaging study first and with the imaging study it tells you, ooh, that problem is it lumbar three dash lumbar four. And we talk about places in the lumbar spine with generally two numbers so that we can stay oriented. It’s like coordinates on a map so it gets us to the right place and that way the steroid can be delivered by a physician in the form of an injection right to the right place so that it could have the highest concentration there. With that injection, there are systemic effects. For instance, your whole body does see the steroid, just like as if you took it as a pill, but the ground zero as it were, sort of like with a bomb is where the most of it is going to be and do its job and so you can get a higher concentration. That’s why it’s advantageous.
