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Special items and suggested setup for this procedure: 22g x 5 quincke needle (a 3.5 needle can also be used in most patients but might not be long enough in some patients) 2-3cc local anesthetic (such as dilute 0.125% bupivacaine) and desired steroid (such as dexamethasone 10mg) in 5cc syringe as primary injectate 3cc contrast 3-5cc 1% lidocaine in 5cc syringe with 25g x 1.5 hypodermic needle for subcutaneous anesthetic Landmarks and Patient Positioning Position the patient in a basic prone position so that the bottom of the c-arm can go under the table below the hip/sacrum on the treatment side

Massage in gentle upward circular motions until fully absorbed

According to the institutional review board (IRB) no formal research ethics approval or research and development approval was required as stipulated by the UK Policy Framework for Health and Social Care Research and the Health Research Authority decision tool

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