In this highly selective group of professional athletes, our results suggest that epidural steroid injections are a safe and effective therapeutic option in the treatment of symptomatic lumbar disc herniation.

Chronic peripheral nerve pain is a common problem that can arise from numerous causes, for which neurolysis is a therapeutic option. It is postulated that cryotherapy will have less adverse events than other methods of nerve ablation. A retrospective case series review was performed in patients who had undergone sonographically guided cryoneurolysis for Morton neuromas, postsurgical and posttraumatic neuromas, and idiopathic neuralgia. Fifteen of 20 patients had a positive response to cryoneurolysis, as did 2 of 4 patients with borderline symptoms for chronic regional pain syndrome. In view of our positive results, we believe that cryoneurolysis should be considered a reasonable option in performing neurolytic therapy.

Background and Aims: There is minimal literature on the efficacy of epidural steroid injections in the professional athlete population. Literature regarding long term success of epidural steroid injections is inconclusive, and does not support their use to improve long term functionality or to avoid surgery. Moreover, in the short term, a common criticism of epidural steroid injections is that they do not improve average functional impairment. This study elucidates the dramatic clinical efficacy of epidural steroid injections in the professional athlete. Methods: We performed a retroactive series of case studies of eleven professional football players receiving epidural steroid injections for incapacitating pain secondary to herniated nucleus pulposus. Functional impairment was measured by an initial VAS pain scale, and inability to play. Success was measured simply by return to play status. Results: Eleven players had 25 total injections. Only two did not return to play. Nine did return to play, with 12 total games lost. After 17 of the 25 injections, the player returned to play without missing any games. No complications were reported. Conclusions: In professional athletes with high baseline functionality, results suggest epidural steroid injections are extremely effective in treating symptomatic herniated nucleus pulposus. They appear to be safe and well tolerated, with minimal complications, thus enhancing compliance with physical therapy while reducing the need for surgery.

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