Epidural Steroid Injections for Low Back Pain
Lower back pain and sciatica are more common than most believe. Pain can be mild or severe, affecting your back and legs. Lumbar epidural steroid injections (ESIs) may be able to help, though. These injections are for the management of back and sciatica pain. They are an integral part of non-surgical treatment.
Local anesthetics administered into your spine. The epidural space surrounds the cord and nerve roots. Then, a steroid medication is injected directly into this space. Direct injections like this work take effect right away.
Steroid injections are ideal for the following:
- Reduce inflammation around the nerve roots
- Control pain
- Improve mobility and function
Through this, patients can take part in physical therapy. With reduced pain and better mobility, they can heal.
Often an epidural injection is part of a series of non-surgical treatments. You will also have medications and physical therapy. Only when this fails will surgery be considered. The injections help rehabilitation during physical therapy sessions.
Benefits of Epidural Steroid Injections
Most professionals agree that these injections are ideal for acute pain relief. However, pain relief is usually temporary. Because everyone’s body reacts differently, they may not be successful for you. If one injection is beneficial, you may get up to 3 a year.
Some of the benefits of ESIs include:
- Reduced nerve pain and inflammation. Steroids reduce the production of inflammatory chemicals. Therefore, generating fewer pain signals.
- Postpone surgery. Pain relief and effective physical therapy can prevent surgery.
- Limit medications. Pain-relieving medications come with side effects. Steroid injections can eliminate the need for these drugs.
- Effective physical therapy. Reduced pain allows you to continue or start physical therapy. Rehabilitation is more effective when a person completes PT.
Treatment with an ESI depends on the underlying cause of pain. So, your doctor will first evaluate your condition. Then, if it will be beneficial, you may receive ESIs.
Epidural injection Approaches
ESIs deliver significant relief due to being placed directly by spinal nerves. There are different techniques to administer them, such as:
Transforaminal route: This is precise administration into the epidural space. Specific nerve roots are targets to control pain and inflammation.
Interlaminar route: First, the surgeon begins by inserting the needle into the back of the spine. However, this technique is not as precise as others. The steroid is not dropped directly by the affected nerves. So, it can spread through the epidural space.
Caudal route: This is the simplest of the techniques. However, the steroids do not go directly to the source of pain. And although considered safer and the easiest, this way is not always as effective. But it can help with more widespread pain.
Your doctor will choose a technique to use based on your diagnosis and your previous results. Additionally, your physician may also have a working preference.
Effectiveness of ESIs
In general, the injections deliver favorable results. In fact, most people report pain relief that lasts months! Now, if the first injection was successful, another one can be considered successful. However, no more than three are allowed within a year. Reportedly, there are short-term benefits, but the long-term use of injections is controversial. Mostly due to research limitations such as:
Studies not using fluoroscopy to verify placement of steroids
Studies not classifying patients appropriately
Therefore, due to these flaws in research, additional is necessary, especially for long-term use.
When to Use Epidural Steroid Injections
ESIs are used to alleviate inflamed spinal nerve roots. The most common conditions causing this pain are as follows:
- Lumbar herniated disc
- Degenerative disc disease
- Lumbar spinal stenosis
- Localized back pain
- Neurogenic Claudication (less common)
Some specific locations and doctors will perform ESIs. It’s common for them to be adequately in hospitals, clinics, or surgery centers. Several different types of doctors can accomplish this, such as:
- Spine surgeons
- Radiologists
- Neurologists
- Anesthesiologists
If you are considering ESI’s and would like more information, call us at 888-409-8006. Our top pain management specialists are ready to answer any questions you may have.