Spine-related pain is the top cause of workplace disability worldwide. It’s also a common symptom associated with personal injuries.
If there is a desire to avoid surgery and keep symptoms in check, you may be a good candidate for epidural injections. Also referred to as epidural steroid injections (ESIs), injections of this nature are administered directly into the affected area to help manage pain by controlling inflammation.
What Is an Epidural Injection?
An epidural injection usually includes a combination of a local anesthetic and a steroid medication, or corticosteroid. These injections are so-named because they are delivered into what’s referred to as the epidural space of the spine. This is the area between vertebrae and a protective dura sac that surrounds the spinal cord and spinal nerves. Epidural injections work by washing away certain proteins associated with inflammation.
Who Is a Good Candidate?
Generally, individuals with lower back, neck, or radiating arm or leg pain tend to benefit from epidural injections. ESIs also tend to work well on patients inflammation-based sources of spine-related discomfort. It’s not meant as a treatment option for individuals with bleeding issues or those with active infections. However, you may benefit from epidural injections if your symptoms are related to any of the following conditions:
- Sciatica
- Disc herniation
- Vertebral slippage (spondylolisthesis)
- Spinal stenosis
- Age-related spinal disc wear (degenerative disc disease)
How Is an Epidural Injection Given?
Patients taking blood thinning medications may need to stop doing so prior to receiving an epidural injection. It’s also important to disclose all medications you are taking. Injections are usually given as an outpatient procedure. A local anesthetic is used to make the injection process more comfortable. Some patients are also given a low-dose oral sedative.
The needle is inserted with the assistance of a special type of live X-ray (fluoroscopy). This is done to make sure the correct location is targeted. A contrast dye is injected as well to confirm that the medication is flowing to the intended location. Once the needle is correctly positioned, the combination of the anesthetic and corticosteroid medication is injected into the area around the nerve roots in the epidural space.
What Happens Afterward?
If relief is experienced after the injection, it’s usually assumed that the correct source of a patient’s pain has been targeted. There may be some lingering soreness around the injection site, although over-the-counter medication or the application ice usually helps minimize this type of discomfort.
There might be a slight uptick in pain when the anesthetic wears off before the anti-inflammatory medication takes full effect. Patients are usually encouraged to participate in a related physical therapy plan while experiencing relief from the injections, which are typically given in 1-4 week intervals. The duration of relief experienced can range from weeks to years.
Epidural injections aren’t meant as the first attempt at managing spine-related pain. But if pain medications and other initial treatments aren’t effective, the long-term relief that may be experienced with injections could make it easier to fully participate in physical therapy or rehab sessions. There are few serious risks associated with epidural injections.