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Minimally Invasive Pain Institute

Pain Management Procedures

Lysis of Adhesions Lumbar Spine

The epidural lysis of adhesions is a procedure that was developed to help decrease chronic low back pain due to adhesions and scar tissue formation. A common cause of chronic low back pain is excessive scarring in the epidural space. The epidural space is a thin area between the inside of the vertebral column and the protective layer around the spinal cord. The purpose of epidural lysis of adhesions is to eliminate the deleterious effects of scar formation, which can physically prevent direct application of drugs to nerves or other tissues to treat chronic back pain. The goal of epidural lysis of adhesions is to assure delivery of high concentrations of injected medications into target areas.


  • The epidural lysis of adhesions procedure is an outpatient procedure performed in one of our state of the art procedure rooms.
  • For your safety and comfort, the physician or nurse may start an intravenous line and give some medication to help you relax.
  • Mild sedation is used because your participation in the procedure is critical to reduce the risk of any complication.
  • The area to be injected is cleansed thoroughly, and a numbing agent will be injected deep into your skin and tissue.
  • After the numbing medication takes effect, the physician will introduce an epidural needle through the skin into the sacral hiatus.
  • Following placement of the epidural needle, the catheter is advanced into the injection site.
  • The movement of the catheter is continuously monitored using a real-time special x-ray machine (fluoroscope) to assure safe and effective positioning.  
  • During the placement of the catheter, you will be asked how a certain stimulus may feel or be asked to follow certain commands (e.g. move your toes).
  • Once the catheter is in place, medication can be injected to relieve pain at the source and dissipate the scar tissue.  

How does it Work?
This procedure helps break down scar tissue that causes pain in the lower back. The physician may use enzymes to dissolve some of the scar tissue. After the scar tissue is removed, an anti-inflammatory agent is administered to help relieve pain. The steroid is used to reduce the inflammation and/or swelling of the nerves in the epidural space, to therefore reduce pain, tingling, and numbness and other symptoms caused by nerve inflammation, irritation, or swelling.

After the Procedure
You may experience some weakness and/or numbness for a few hours after the procedure. You will be unable to drive for the remainder of the day following the lysis of adhesion procedure. It is best to have someone else drive you home and accompany you to your home. This person should also be available to you should you require assistance at any time after your procedure.

For a better understanding of interventional pain treatment services, contact the healthcare professionals at Minimally Invasive Pain Institute.  They can help customize a treatment for you and your acute or chronic pain condition. To find out if you are a good candidate, or for more information on this and other pain treatment services, read on or contact our pain management center.  Together, we’ll help you find the relief you need for the quality of life you deserve.