Epidural Injection FAQs from a Chicago Pain Clinic

16 Mar Epidural Injection FAQs from a Chicago Pain Clinic

Posted at 09:51h in blog by Premier Pain & Spine

Used since the 1950s, epidural steroid injections have an average success rate of over 75 percent in treating “radicular pain” in the neck and back. A safe process of administering medications directly into the pain are adjacent to the spinal cord, these injections have sciaticaproved their efficacy in reducing a range of painful cervical and lumbar disorders. When used along with other pain management therapies, epidural steroid injections may lead to more than 95 percent pain relief over an extended period.

What is an Epidural Steroid Injection?

Epidural steroid injections inject medication to an area around the spine responsible for radiating pain that is usually traced to irritation or inflammation in the nerve root. The process derives its named from the epidural area, the space around the spinal cord, to which the medication is injected. It is this epidural area where pinching of nerve occurs and pain originates from. When the medication is injected to it directly, the inflamed nerves recover and the pain subsides.

What are the Different Types of Epidural Steroid Injections?

There are three types of epidural injections used to treat painful symptoms.

  • Interlaminar or administration of epidural injection through the thin layer between two vertebrae on the mid-line of the back. It is effective for short term.

    [caption id="attachment_1766" align="alignright" width="300Lumbar Transforaminal Epidural Lumbar Transforaminal Epidural[/caption]

  • Transforaminal or epidural steroid injection administered from the side of the vertebra. This is the newest type of epidural and places the steroid medication as close as possible to where the compression is occurring.
  • Caudal or epidural injection through the tailbone area using a catheter. Used to impact a group of nerve roots at a time, the procedure is effective to treat pain linked to spinal stenosis, post-herpetic neuralgia, and also a herniated disc problem.

What Conditions Are Treated Through Epidural Steroid Injection?

  • Pain associated with spinal stenosis
  • Radiculopathy
  • Radicular cervical pain
  • Radicular lumbar pain
  • Neck pain following spondylysis
  • Pain due to degenerative disc
  • Herniated disc pain
  • Leg pain following sciatica
  • Radiculitis or nerve root inflammation
  • Bilateral radicular pain

Why Should I Go For Epidural Steroid Injection?

Epidural injections don’t cure the pain, but soothes the area so that patients get relief from painful symptoms. The popularity of these anti-inflammatory injections primarily rests with pain relief3their high success rate scoring well above the surgical option. Not only the pain is subdued over an extended period of time, but also the procedure is less invasive and virtually painless.

How Is an Epidural Steroid Injection Performed?

The outpatient process involves use of intravenous sedatives prior to the injections, though it is not necessary. A local anesthetic helps numb the skin above and soft tissues surrounding the pain spot and a needle is placed using fluoroscopic x-ray into epidural area radiating the pain.

Dye is typically injected to confirm the correct position. Then, numbing medication and steroid are injected to treat the inflamed nerve roots.

What Is Injected During Epidural Injection Procedure?

Epidural injections contain a local anesthetic and a steroid. While the first disrupts the pain signals, the second treats and cuts down nerve root inflammation. The medications spread to the spine and inhibit the pain symptoms.

How Long Does It Take?

It takes between 15 to 30 minutes to complete the procedure.

Do I Need Rest After Epidural Steroid Injection?

  • Patients are discharged after the procedure.
  • Rest of a day is advisable.
  • Engage in activities you can tolerate and gradually increase the load on the injection site.

What Are The Side Effects of Epidural Steroid Injection?

There are no major side effects when the standard treatment procedure under fluoroscopic guidance is followed. Failure to do so may damage nerves and soft tissues and cause bleeding. Prior to the procedure, inform doctors if you have high diabetes, allergy to steroids, or other medical conditions to avoid any complication.

Rest helps overcome injection-site soreness, the most common experience patients have after the injections, in a day or two.

How Well Does Epidural Steroid Injection Work? What Are The Benefits of Epidural Steroid Injection?

  • According to the Journal of the American Medical Association, epidural steroid injections gives equal relief as surgical intervention for herniated disc with sciatica without any major risk.
  • A research trial reported in the Skeletal Radiology journal cited immediate pain relief in 72 percent cervical radiculopathy patients treated with these injections. Italian researchers from the University of Pavia also discovered similar benefits.
  • Multiple research studies have attested 75 to 90 percent efficacy of epidural steroid injections.
  • In 2007, a Florida Spine Institute study reported that bilateral radicular pain associated with spinal stenosis subsides considerably with these injections allowing great improvement in walking and standing conditions.
  • Another 2007 report in Pain Physician recommended epidural steroid injections for successful management of lumbar back pain.

References

Weinstein SM, Herring SA: NASS. Lumbar epidural steroid injections. Spine J 3(3 Suppl):37S-44S, 2003.

Lutz GE, VAd VB, Wisneski RJ: Fluoroscopic transforaminal lumbar epidural steroids: an outcome study. Arch Phys Med Rehabil 79:1362-1366, 1998.

Botwin K, Brown LA, Fishman M, Rao S; Fluoroscopically guided caudal epidural steroid injections in degenerative lumbar spine stenosis. PubMed

Young IA, Hyman GS, Packia-Raj LN, Cole AJ; The use of lumbar epidural/transforaminal steroids for managing spinal disease. J Am Acad Orthop Surg. 2007 Apr;15(4):228-38

Lin EL, Lieu V, Halevi L, Shamie AN, Wang JC; Cervical epidural steroid injections for symptomatic disc herniations. J Spinal Disord Tech. 2006 May;19(3):183-6.

Kwon JW, et al; Cervical interlaminar epidural steroid injection for neck pain and cervical radiculopathy: effect and prognostic factors. Skeletal Radiol. 2007 May;36(5):431-6. Epub 2007 Mar 6

Abdi S, et al; Epidural steroids in the management of chronic spinal pain: a systematic review. Pain Physician. 2007 Jan;10(1):185-212.

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