Epidural steroid injection or physical therapy for lumbosacral radiculopathy due to disc herniation?

Abstract

A 58-year-old male presents to his physician with complaints of low back pain for the past 4 months. The pain is sharp and burning and radiates down the back of his left leg to the bottom of the foot. There is a tingling and occasional numbness on the sole of his foot. He has tried taking nonsteroidal anti-inflammatory agents (NSAIDs) with minimal benefit, and finally decided it was time to get the pain checked as golf season was around the corner, and he did not want it to impact his game. A magnetic resonance imaging (MRI) scan is performed and reveals a small central left paracentral disc herniation at L5-S1, which partially effaces the ventral thecal sac.