Epidural Adhesiolysis (Racz Catheter)

Wessex Pain Clinic

Epidural Adhesiolysis (Racz Catheter)

Epidural adhesiolysis using a Racz catheter is a specialist procedure aimed at reducing pain caused by scar tissue and adhesions around spinal nerves. It involves placing a fine catheter into the epidural space to break down scar tissue and deliver targeted medication to relieve nerve irritation.

How the Procedure Works

Following spinal surgery, injury, or chronic inflammation, scar tissue can form around the spinal nerves, binding them and preventing normal movement — a condition sometimes referred to as epidural fibrosis. This can lead to persistent nerve pain that does not respond to standard treatments.

The Racz catheter technique involves inserting a specialised, flexible catheter into the epidural space through the sacral hiatus (lower spine). Under continuous X-ray guidance, the catheter is gently guided to the area of nerve entrapment. A combination of local anaesthetic, steroid, and saline (sometimes with enzymes) is then delivered to help break up adhesions, reduce inflammation, and restore nerve mobility.

What Conditions It Can Help With

Epidural adhesiolysis may be appropriate for:

Persistent nerve pain following spinal surgery (post-laminectomy or “failed back” syndrome)

Epidural fibrosis or scarring from previous interventions

Chronic sciatica or radiculopathy not relieved by standard epidural injections

Nerve entrapment following disc herniation or spinal stenosis

Complex cases where nerve pain persists despite conventional treatments

It is often considered when other conservative or interventional treatments have not been effective.

Aimed Benefits

The goal of epidural adhesiolysis is to:

Reduce pain caused by nerve root scarring or entrapment

Improve nerve mobility and reduce mechanical irritation

Enhance the effectiveness of other treatments such as physiotherapy

Help avoid or delay more invasive interventions such as further surgery

Relief can vary depending on the extent of scar tissue and underlying spinal changes.

What to Expect

This is a more advanced outpatient procedure. You’ll be positioned comfortably and the lower back area will be numbed with local anaesthetic. Sedation is usually offered.

Using X-ray guidance, your consultant will insert the Racz catheter into the epidural space and guide it to the affected area. Medication is then delivered to soften and break down adhesions. You will be monitored after the procedure and may be advised to rest for the remainder of the day.

Some people experience temporary discomfort as nerves are manipulated or become unbound from scar tissue. Any increase in symptoms is usually short-lived.

Risks and Considerations

All procedures carry some risks, which will be discussed in detail with you during your consultation. You will have the opportunity to ask questions, and formal consent will always be obtained before any procedure is carried out.

Combined Approach / Multidisciplinary Care

At Wessex Pain Clinic we find that the best results come from combining medical treatments with active rehabilitation. Procedures are often most effective when paired with physiotherapy, movement-based exercise, and — where appropriate — psychological support. This comprehensive approach addresses both the physical and emotional aspects of pain and supports longer-term improvement.

Key Points Summary

Advanced consultant-led procedure for nerve pain with scarring
Involves targeted medication delivery via a Racz catheter
Aims to break down adhesions and restore nerve mobility
Considered for persistent post-surgical or chronic nerve pain
Often used when other injections have not provided sufficient relief

Disclaimer

Results vary between individuals and cannot be guaranteed. Your consultant will discuss whether this procedure is appropriate for you.

At Wessex Pain Clinic, we work as a team and meet regularly to discuss complex, treatment resistant or unusual cases. As such you will often receive the expertise of several pain consultants. We believe that we are one of very few pain clinics to offer this.

Driving advice: You should not drive that day if receiving any sedation. Our procedures do vary on whether they are possible to drive home from yourself, please seek advice from your consultant about driving advice. If you are seeing us for an injection and planning on driving, please check with us beforehand about whether it will be possible to drive yourself home afterwards.

Wessex Pain Clinic provides consultant-led assessment and treatment for acute and chronic pain conditions. Our multidisciplinary team includes Consultant Pain Specialists, Physiotherapists and Psychologists, offering evidence-based interventions alongside rehabilitation and self-management support. We welcome patients from across Hampshire, Dorset, Wiltshire, Surrey and Sussex, including Winchester, Basingstoke, Southampton, Portsmouth, and Chichester – with both in-clinic appointments and remote consultations available across the wider Wessex region.

Marvin Woodrow

One visit and my pain problems have been resolved. Will definitely use again if the need arises. Can recommend Dr. Tom Bloomfield as he is very professional and communicates all aspects of the procedure so that it is understandable.

Jennifer Rudder

Dr Bloomfield is amazing. He has helped me so much. He clearly lives what he does and because of that is truly engaging and listens. I am so pleased with the outcome too, I feel much more myself and have confidence that my issue will become a thing of the past. I highly recommend seeing Dr Bloomfield for any issues you may have with pain.

Evie Cox

I highly recommend Dr Bloomfield at the Wessex Pain clinic! I was referred to Dr Bloomfield after 18 months of unrelenting knee pain which had stopped me from all activities I had previously enjoyed, even simply walking my dog each day. All previous treatments had been unsuccessful in reducing my pain, but Dr Bloomfield recommended trying a nerve block to reduce my pain levels. He was incredibly gentle and compassionate during the procedure and in all consultations, and his approach to managing and treating pain from all different angles in life is refreshing! Two weeks on from the procedure and I have been able to get back to walking my dog daily and I'm very much looking forward to increasing my activity levels again now that my pain levels have dropped so significantly. I can't recommend Dr Bloomfield enough, thank you for giving me back my freedom of movement!

Roger Christie

Dr. Bloomfield was very helpful, kind and considerate. He listened, discussed concerns, explained everything and gave us time, something nowadays one does not always receive. He understood the pain I was experiencing and I am hoping that the treatment options suggested will work in the long term. The clinic itself is well presented and welcoming.

Sarah Clark

I saw Dr Bloomfield this week at Wessex Pain Clinic and was incredibly impressed by both his medical knowledge and communication skills. He was efficient, empathetic, and validating throughout the appointment. I received a copy of his clinic letter just three hours after our consultation, which was outstanding. He also shared some excellent ideas for pain management interventions that felt thoughtful and tailored to my needs. I'm a complex patient with a very complicated medical history. I would thoroughly recommend both Dr Bloomfield and Wessex Pain Clinic to anyone seeking expert and compassionate care.

Jacek Omilian

I’m really grateful to Dr Hyde for her time, clarity, and kindness during my pain management consultation. I came in worried that my ankle pain might be turning into something chronic or more serious. She took my concerns seriously, explained everything in a way I could understand, and helped me feel much more reassured. She combined medical knowledge with real empathy something I really appreciated. I left with a clear plan, including medication advice and practical steps to reduce the risk of long-term pain. This was one of the most helpful and supportive consultations I’ve ever had. Thank you.

Hannah Farrell

My treatment with Dr Hyde was exactly what I needed to help my pain. Incredible, personal service I will defiantly be back.

Wessex Pain Clinic

Dr Matt Stubbs

Consultant in Pain Medicine FRCA FFPMRCA

Dr Eleanor Hyde

Consultant in Pain Medicine FRCA FFPMRCA

Dr Tom Bloomfield

Consultant in Pain Medicine FRCA FFPMRCA

Dr Jo Harding

Consultant in Pain Medicine FRCA FFPMRCA

Wessex Pain Clinics

Epidural Adhesiolysis (Racz Catheter)

Wessex Pain Clinic