Epidural Pain Management
Chronic low back pain can be a debilitating experience. Standing, walking, exercising, or even just getting out of bed in the morning can feel like a chore and sap the enjoyment out of life. When popping a few Tylenol just isn’t cutting it, you need more direct relief. One pain relief option is an epidural steroid injection (esi).
An epidural injection is an injection of medication into the epidural space around the spinal cord, to provide temporary or prolonged relief from inflammation or pain. Located outside the dural membrane, the epidural space is the outermost part of the spinal canal. a Cocktail of steroids, anesthetics and anti-inflammatory medications are typically delivered in an epidural injection. The injection may reduce pain and swelling in and around the spinal nerve roots, as well as around damaged nerves which in time may heal.
Imaging guidance, such as fluoroscopy or computed tomography (CT or “CAT” scan), may be used to assist the doctor place the needle in the right location to target the specific area causing the pain so the patient can receive maximum benefit from the epidural injection.
Epidural steroid injections are an excellent option for low back pain relief. They’re especially effective for spinal nerve irritation. Many doctors use epidural injections to relieve pain during and after surgery, as well as managing chronic pain.
The procedure may not be for everyone. But as an option, it requires a lower dose of medicine and as a result, has fewer side effects.
But Aren’t Epidurals for Women in Labor?
Pain specialists recommend epidurals for many different kinds of pain, in both men and women. If you can imagine how much pain epidurals need to block out for new moms in labor, then you can see how an epidural is one of the most effective delivery systems known for rapid pain relief!
Epidurals for Back Pain
An epidural for back pain is a minimally-invasive treatment option for patients who haven’t seen success with more conservative approaches, like rest or over-the-counter medication. The treatment can be combined with physical therapy for even greater results.
Epidurals are often recommended for painful conditions affecting the spinal nerves, including:
- Lumbar spondylosis
- Bulging of lumbar intervertebral disc
- Lumbar degenerative disc disease
- Lumbar Facet Joint Pain
Epidurals for Neck Pain
Epidural injections can also provide relief for spinal pain in the neck, including:
- Pain of cervical facet joint
- Cervical spondylosis without myelopathy
- Bulging of cervical intervertebral disc
- Cervical spinal stenosis
- Cervical spondylosis with radiculopathy
Epidural Steroid Injection FAQs
Here are some FAQs to help you learn more about epidural injections.
What goes into an epidural steroid injection?
The medication includes a corticosteroid and an anesthetic, such as lidocaine. The medications work together to numb the area for instant relief and reduce inflammation for long-term relief.
How does an epidural injection work?
While laying down on an x-ray table, a local anesthetic will be used to numb the treatment area (injection site) to keep discomfort minimal during the procedure. You will remain awake and aware during the injection to provide feedback to the doctor. The injection is delivered into the epidural space of your spine. That’s the space between the bone tissue and the protective covering of the spinal nerves, called the dura. This space is full of fatty tissue and blood vessels. The medications enter your bloodstream and flush away the proteins that are causing the inflammation.
With the aid of x-ray fluoroscopy, the doctor will direct a hollow needle through the skin and between the bony vertebrae into the epidural space. Fluoroscopy allows the doctor to watch the needle in real-time on the x-ray monitor, ensuring that the needle goes to the desired location. Some discomfort may occur, but most commonly feel pressure than pain.
Fluoroscopy dramatically improves your doctor’s accuracy in placing the tip of the needle.
Fluoroscopy: The epidural space is very small, and it is located deep within your vertebrae. An epidural injection can either be performed “blind,” or under X-ray guidance with fluoroscopy.
The choice is yours, but we highly recommend fluoroscopy. Fluoroscopy dramatically improves your doctor’s accuracy in placing the tip of the needle, increasing the odds that your treatment will work as intended.
What are the side effects of an epidural injection?
Following your epidural injection, you may feel some numbness or muscle weakness. This should clear up within a few hours. You may also feel a slight increase in pain, as the numbing agent wears off and the steroid starts to kick in.
Common side effects include a drop in blood pressure, trouble urinating, headache, water retention, weight gain, hot flashes, insomnia, and mood swings. Many patients report no side effects at all. Rare complications may include bleeding in the epidural space, nerve damage, and infection.
Patients with an infection or bleeding disorder should not have epidural injections. Steroid injections can also raise blood sugar levels in patients with diabetes. Talk with your doctor to find out if you are a good candidate.
How long does an epidural injection last?
Pain relief times vary from person to person, depending on your body composition and the severity of your pain. Epidural injections pain relief may be short term or may last for several days, a few weeks and for some even years.
A follow-up appointment will determine your response to the treatment. You may receive a repeat injection, usually in 1-4 weeks. The interval length for your individual condition may vary as well. Doctors tend to be cautious in prescribing steroid injections because it can be risky to receive too many within a given period of time. Your doctor will take your individual case into account to determine how much medication is safe for you.
Call Nuvo Spine for Epidural Pain Relief
At Nuvo Spine, we specialize in minimally-invasive, non-surgical treatments for neck, spine, and nerve pain. Our award-winning, board-certified health care physician is a leading expert in advanced pain management and will work with you to get you the pain relief that you deserve. Call our offices today.
Dr. Vahedifar's pain management strategies integrate cutting-edge medical technology with targeted interventions to minimize pain and treat pain’s underlying causes.
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