Epidural Steroid Injections
Pain Relief through Epidural Steroid Injections
The epidural space is the area just outside of the sac of fluid around your spinal cord and the large nerves that leave your spinal cord. Injections of steroids in this epidural space reduce the inflammation and/or swelling of nerves. This may in turn reduce pain, tingling, numbness, and other symptoms caused by nerve inflammation/irritation or swelling.
Conditions helped by epidural steroid injections
Epidural steroid injections are used to treat conditions that affect the spine from the neck to the lower back. These conditions include:
- Herniated discs
- Protruding discs
- Degenerated disc
- Osteoarthritis of the spine
- Spinal stenosis
- Scar tissue or other changes following neck or lower back surgery.
Epidural steroid injection procedure
The procedure involves inserting a needle through skin and deeper tissues so there is some discomfort involved. The doctor will use a local anesthetic ("numb") using a very thin needle prior to inserting the epidural needle. The procedure is typically done with the patient sitting up or lying on his or her side.
Pain relief effects
Immediately after the injection, you may notice that your pain may be gone or quite less. This will last only a few hours. Your pain will return and you may have a "sore back" for a day or two. It usually takes one – three days for the corticosteroids to have their effect. However, some patients take up to seven days to notice the full effect. Most patients experience partial relief after the first injection. Subsequent injections are performed to increase the degree of pain relief.
The injected depot-corticosteroids are fat-soluble and generally are active for about one month. However the clinical relief depends on several factors. The most important is the nature of the patient’s condition. In some cases, healing after injury may take six months to one year. In other cases, the condition is chronic and injections may be needed on an intermittent basis (up to three times a year). Patients are encouraged to go through physical therapy for strengthening exercises during the period of time when the pain has been reduced.
Physical therapy and rehabilitation is essential in treating many patients with spinal conditions. By making the muscles around a spine into a “muscular corset,” loads can be reduced on the nerves, disks, and joints of the spine. One of the major goals of the epidural steroid injection is to reduce pain and allow the patient to participate more effectively in physical therapy.
If you do not receive benefit from the epidural injection, other structures may be responsible for your pain. This could include the disk, joints, ligaments or muscles surrounding the spine. You may require further imaging studies or other diagnostic injections to better identify and treat the source of your pain.