Overview
Epidural lysis of adhesions and PRP may be considered when persistent leg pain or sciatica continues despite previous treatment. Scar tissue within the epidural space can trap or tether spinal nerves, limiting their normal movement and blood flow. This may lead to ongoing nerve related pain, especially when other injections have provided limited benefit.
Epidural lysis of adhesions and PRP aims to break down scar tissue, restore nerve mobility, and allow treatment to reach the affected area more effectively. In selected cases, PRP may be added to support healing and recovery as part of a broader treatment plan.
Who this treatment helps
Epidural lysis of adhesions and PRP may be considered for people with:
- Persistent leg pain after spinal surgery
- Suspected epidural scarring
- Limited response to epidural steroid injections
- Chronic nerve related leg pain
- Sciatica symptoms linked to adhesions around the nerves
- Ongoing pain affecting walking, activity, or sleep
A consultant assessment is needed to confirm whether this treatment is appropriate and whether scar tissue is likely to be contributing to symptoms.
What is epidural lysis of adhesions and PRP
Epidural lysis of adhesions and PRP is a specialised image guided procedure. A fine catheter is guided into the epidural space so that scar tissue can be gently disrupted and medication delivered directly to the affected nerves.
PRP may be introduced in selected cases to support the local healing environment. The aim is to improve access to the irritated area, reduce ongoing nerve related symptoms, and support better movement and function over time.
What to expect during the procedure
Your consultant will explain the treatment plan in detail before the procedure. In general, the process may include:
- Consultant assessment and confirmation of the treatment target
- Skin preparation and sterile setup
- Image guided catheter placement into the epidural space
- Gentle release of adhesions around the affected nerves
- Delivery of medication and PRP where appropriate
- Monitoring after the procedure before discharge
The exact steps may vary depending on previous surgery, imaging findings, and the location of symptoms.
After the procedure
It is normal to experience some temporary discomfort after epidural lysis of adhesions and PRP. Recovery can vary depending on the level of nerve irritation and the chronicity of symptoms.
- Temporary increase in pain or soreness may occur
- Improvement is often gradual rather than immediate
- Tolerance to activity may improve over time
- Rehabilitation is often recommended as part of recovery
Your consultant may advise activity modification, follow up review, and a staged return to walking or exercise depending on your progress.
Benefits
- Targets scar tissue directly within the epidural space
- May improve nerve mobility
- May reduce chronic leg pain and sciatica symptoms
- Minimally invasive compared with open surgery
- Can improve treatment delivery to the affected nerves
- May support recovery in selected cases when PRP is added
Possible risks and side effects
As with all spinal procedures, epidural lysis of adhesions and PRP carries some risk, although serious complications are uncommon when performed by experienced clinicians.
- Temporary increase in pain
- Local soreness
- Bruising or mild bleeding
- Infection, which is rare
- Very rare nerve irritation
- No meaningful improvement in some cases
Your consultant will explain the potential risks, expected benefits, and alternatives based on your medical history and previous treatment response.
When to consider other options
If epidural lysis of adhesions and PRP is not suitable, or if symptoms suggest a different pain source, other options may be discussed. These may include epidural steroid injection, lumbar nerve root block and PRP, rehabilitation, medication review, or further specialist assessment depending on the diagnosis.
Safety note
Please inform your consultant about previous spinal surgery, current medications, allergies, diabetes, bleeding disorders, active infection, pregnancy, or other medical conditions that may affect treatment planning. Depending on the medicines used during the procedure, you may need someone to accompany you home.
Arrange a consultation to discuss whether epidural lysis of adhesions and PRP may be suitable for persistent leg pain or sciatica.
You can also explore our leg pain and sciatica treatments, view all pain treatments, or learn more about related care within our pain management services.