When you have serious back pain, your doctor will consider all possible treatments that could help you. The treatments can range from exercise and physical therapy to medication. The treatment can include injections to ease your back pain and inflammation. Epidural steroid injection (ESI) is a good treatment option for those patients suffering from many forms of lower back pain and leg pain.
This treatment option has been used for decades and is considered an integral part of the non-surgical management of neuralgia and lower back pain. The injection is named an epidural steroid injection as it involves administering a local anesthetic medication and a steroid medication directly into the epidural space surrounding the spinal cord and nerve roots. The term epidural means around the spinal cold. The main goals of epidural steroid injection are to control pain by reducing inflammation in and around the nerve roots. These injections can also improve mobility and function in the lower back and legs.
How Long Do Back Epidural Injections Last?
Physicians may recommend epidural steroid injections for pain that is chronic in nature. For pain relief, the healthcare provider injects steroid or corticosteroid medication into the epidural space of the spinal cord in your lower back. The lumbar spine is the lower back region of your spine.
This is made of five vertebrae, and these vertebrae largest of your spine. Between these vertebral bones, there are disks that provide cushioning for your vertebrae and flexibility for your body. Lumbar vertebrae have several important roles in supporting and stabilizing your upper body and allowing twisting and bending movements. Our spinal cord contains an important bundle of nerves that runs from your brain to your lower back. It is like a super highway that connects nerves located all over your body to your brain. Through this brain can communicate with the rest of your body.
There are possibilities for the nerves that are attached to the lower back region of your spinal cord can become pinched or inflamed. This can happen in case you have a herniated disk. These inflamed nerves can cause pain that can spread down to your legs. The steroid is injected into the epidural space around your spinal cord during the lumbar epidural steroid procedure. The steroid works on the irritated nerves that are causing the pain. It also reduces swelling and pressure on the nerves. Lumbar epidural steroid injection most of the time helps in temporary pain relief. The results often last for three months or more. But some patients may experience less or no pain relief from the injection.
The anesthetic injected into the epidural space stops pain signals from traveling from your spine to your brain. When the spine undergoes some form of injury, the nerve in that area of the body sends a pain signal that travels through your spinal cord to your brain and back. The anesthetic administered into your epidural area temporarily numbs the spinal nerves, which in turn blocks pain signals in a certain region of your body depending on where along your spine the doctor injected the anesthesia. The effect of the epidural injection depends upon the type of anesthetic drug your physician administers, the concentration of the drug, and the dosage of the drug.
The epidural procedure is performed by an anesthesiologist or a certified registered nurse anesthetist. Anesthesiologists are given special training to help patients during and after a surgery procedure. Healthcare professionals from other specialties such as neurology may also perform epidural injections. A supporting healthcare professional will be present to help in epidural injections that use a catheter. There are two types of epidural injections. They are epidural analgesia and epidural anesthesia. In epidural analgesia pain relief is achieved without losing consciousness and without complete loss of feeling or movement. This is usually used for women who are in labor and delivering a baby. In epidural anesthesia, there is a loss of physical sensation with or without loss of consciousness. In case of surgery, medication to induce sleep is given with epidural anesthesia.
Benefits of getting an epidural injection
There are many advantages of getting epidural steroid injections. Epidural steroid injections give temporary or long-term pain relief. Back pain can be relieved with the help of epidural injections. It is highly likely to have a better quality of life and improved ability to do daily activities without any restrictions that were previously caused by pain. With the help of epidural steroid injections, you can confirm the origin of your pain. This is useful for people who have more than one possible cause of pain. Epidural steroid injections also remove the need for more invasive procedures like surgery for pain management.
Another important benefit of epidural injection is that you can participate in physical therapy or structured exercise program that help you to get relief from pain. Physical therapy and exercises help to strengthen muscles, reduce inflammation, and improve the range of motion. All of these can help to get relief from pain in the long run. By having an epidural injection you can also reduce the need for pain-relieving medication. You could lower the dose of the pain medication after undergoing an epidural steroid injection. Some patients can even eliminate the pain medication altogether.
Epidural injections that are used as anesthesia for surgery also have several benefits. With epidural anesthesia, there is less chance of nausea and vomiting than with general anesthesia. It offers faster recovery after surgery than you would do with general anesthesia. There is also a lower risk of blood in your leg veins than you would if you had general anesthesia. Epidural analgesia is widely used in relieving pain related to labor and delivery.
Risks and side effects of an epidural injection
Epidural steroid injections are generally safe. But there are some risks and possible complications of epidural steroid injections. Although the risks are rare, they have to be noted. These kinds of injections are found to lower blood pressure, which can make you feel dizzy. Epidural steroid injections sometimes cause spinal fluid leakage which can result in a severe headache. Less than one percent of people experience this side effect. There is also a chance of getting affected by infection as a result of the epidural procedure. These can include conditions such as epidural abscess, discitis, osteomyelitis, or meningitis.
Epidural steroid injections can have a negative reaction to the medications, such as hot flashes or a rash. Sometimes during the process of injection, there is a chance for blood vessel damage that can cause bleeding. This can cause a hematoma or a blood clot to form. There are also chances for causing damage to the nerves at the injection site. In some rare cases, the patient may lose control of the bladder and bowels. In such cases, the patient might need a catheter (a small tube) in the bladder to help him/her pee.
Sometimes after an epidural steroid injection, that patient feels a temporary increase in pain. There is also a chance for minimal low-level radiation exposure due to the X-rays if the physician uses fluoroscopy or a CT scan for imaging guidance. Steroid injection causes some complications in patients with diabetes. It can cause high blood sugar or hyperglycemia in them.
Epidural steroid injections are effective in relieving back pain. It is a noninvasive medical procedure and is widely used in pain relief. In the epidural procedure, the pain medication is directly injected into the epidural space of the spinal cord. The epidural steroid injection for pain is generally safe and has lots of benefits. Like any medical procedure, this too has some potential side effects. If you are anxious about getting an epidural injection, try talking with your healthcare provider about it.
Dr. Elizabeth Novello
Dr. Elizabeth Novello specializes in the diagnosis and treatment of disorders of the nervous system. Her clients range across diverse age groups and she works closely with patients to develop a personalized treatment plan that takes into account the individual's medical history and the underlying cause of their pain. Dr. Elizabeth Novello also performs procedures such as lumbar punctures or nerve conduction studies. In addition to diagnosing and treating specific conditions, she focuses on helping patients manage chronic conditions and providing support for patients and their families.
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