Epidural steroid injections (ESIs) are a pain management treatment option for neck, low back, and leg pain. When a nerve root becomes compressed or inflamed as it branches off the spinal cord and exits the spine, it can cause pain that radiates into the arms, hands, or legs. ESIs have been used for decades and are considered an integral part of the nonsurgical management of sciatica, lower back pain, and cervical radiculopathy.
Epidural steroid injections are just one part of a comprehensive pain management program. In addition to the injections, treatment nearly always includes an exercise program to improve or maintain spinal mobility and stability.
An epidural steroid injection quickly delivers pain medication into the body with a syringe. This specific type of injection is called an epidural steroid injection because it involves injecting a local anesthetic and a steroid medication directly into the epidural space. The epidural space is the fat-filled area that surrounds and protects the spinal cord along the surrounding nerves.
Steroids can help decrease inflammation in the body and reduce nerve fibers’ sensitivity to pain, thereby sending fewer pain signals to the brain. The goal of the epidural steroid injection is to provide sufficient pain relief to allow the patient to return to everyday activities and engage in physical therapy. The injection can help reduce inflammation and help provide relief during an acute episode of neck, back, or leg pain.
The injection does not treat the cause of the pain and is not a treatment for most conditions. It is almost always a temporary pain management technique; however, the injections do not work the same on every patient. Typically, up to 3 injections may be given in a twelve-month period.
In addition to a pain management treatment program, spinal injections can be used as a diagnostic tool. Doctors may use epidural injections to help locate the source of pain.
Conditions Treated with Epidural Steroid Injections
Epidural steroid injections are often helpful in treating “difficult-to-treat” pain. Typically, epidural injections are used in treating many conditions that cause inflammation of spinal nerve roots and pains radiating from the spine.
The injections may help relieve pain from conditions such as:
An epidural steroid injection is a procedure performed under X-ray guidance to confirm the medication’s correct placement. The injection consists of the steroid medicine itself, often along with a local anesthetic to help with pain relief. The steroid reduces the inflammation and lessens or resolves the pain.
After the injection, the anesthetic dissipates within a few hours, and the patient may feel a temporary return of pain. Within 24 to 48 hours, the steroid begins to take effect.
Unfortunately, successful pain relief is not guaranteed. Some back pain sufferers experience no benefit or only a small amount of relief. For others, there may be several months of reduced pain and improved function. It is difficult to predict how much pain relief an individual will experience.
How Effective Are Epidural Steroid Injections?
Research indicates generally favorable results for epidural steroid injections. 70% to 90% of patients experience pain relief lasting for a week to a year. If a patient has a positive response to the first injection, a second injection may be considered when the improvement from the first injection begins to taper off.
It is important to point out that steroid injections do not cure the underlying chronic pain condition. For patients who experience a reduction of pain, the pain will typically return.
Why Are Epidural Steroid Injections Limited to Only a Few Each Year?
Epidural steroid injections are usually limited to only a few each year because the steroids in the injection can mimic the effects of the body’s natural hormones cortisone and hydrocortisone.
There is a chance that repeatedly applying steroids to the same area of the body might weaken spinal bones and nearby muscles. Plus, steroid injections can have other side effects, including thinning skin at the injection site or thinning of the soft tissue beneath the skin. Steroids can also cause a loss of color in the skin, facial flushing, insomnia, moodiness, and high blood sugar.
Novus Spine & Pain Center
Novus Spine & Pain Center is in Lakeland, Florida, and treats patients with chronic pain with numerous therapies, including epidural steroid injections. By using a comprehensive approach and cutting edge therapies, we work together with patients to restore function and regain an active lifestyle while minimizing the need for opiates.