Epidural Steroid Injections for Lower Back & Neck-Related Pain
Inflammations that lead to low back leg pain and neck-related arm pain, are treated by a common method called Epidural Steroid Injections or ESIs. Such pain occurs primarily due to two reasons: Spinal Stenosis or Disc Herniation.
When you suffer from Spinal Stenosis, there is a narrowing of the spaces within your spine. This can put pressure on the nerves that travel through the spine. Most often it’s the lower back and the neck that is affected by stenosis. In the case of Disk Herniation, it most often occurs in the lower back, as well as the smaller disks in the neck. Although Disk (aka slipped or ruptured disk) is very painful, it can be treated easily through non-surgical method.
Significance of ESI
ESI constitutes corticosteroids and anesthetic agent. It enters the Epidural spaces of the spine, which is actually the space between the bony vertebrae and the protective dura sac surrounding the spinal nerves and cords. Corticosteroids are effective enough in reducing the pain and the inflammation. Sadly, ESI injection does not make a herniated disc smaller; it only works on the spinal nerves by flushing away the proteins that cause swelling. The pain relief can span for a long time, allowing your spinal condition to improve with physical therapy and an exercise program.
Types of ESI patients
There are different types of Epidural Steroid Injection (ESIs) candidates with pain in the neck, arm, and leg who can get the benefits of ESI.
Here are a few conditions where ESI helps:
- Spinal Stenosis: In this condition, there is a narrowing of the spaces within your spine. This can put pressure on the nerves that travel through the spine causing pain in lower back and neck
- Spondylolisthesis: It is a spinal disorder in which the bone (lower vertebrae) slips forward onto the bone below it. This can compress the nerve roots and cause pain in the body
- Herniated Disk: It is a situation in one of the rubbery disks between the individual bones that combine together to make the spine. The rubbery or gel-like thing sometimes raptures through the weak areas. Irritation, pain, and swelling occur when this material squeezes out and comes in contact with a spinal nerve
- Degenerative Disc: With aging, bones show signs of wear and tear. When normal changes that take place in the disks of your spine, it causes pain
- Sciatica: Sciatica is called as the longest nerve in the body. Pain that develops along the sciatic nerve in the buttocks and down the legs is caused by compression of the 5th lumbar or 1st sacral spinal nerve
How is ESI performed?
The steroid is delivered to the epidural space in 3 ways: the interlaminar, caudal, and transforaminal approaches. These three approaches involve placing a thin needle into position using fluoroscopic (x-ray) guidance. Before the injection of steroid, contrast dye is used to confirm that the medication is traveling into the desired area. To give temporary relief from pain, a local anesthetic is also added along with the steroid.
Back pain is a serious problem but it can be treated timely. Epidural Steroid Injection has an anti-inflammatory agent which is injected around the spinal cord. This injection offers long-term pain relief.
Epidural Steroid Injection has proven helpful in the treatment of painful inflammatory conditions. ESIs can also help in determining whether surgery might be beneficial for pain associated with a herniated disc.
In case of infection or bleeding, ESI should be avoided. Patients with diabetes should be cautious as an injection may slightly elevate the blood sugar level. It may also temporarily level up blood pressure and eye pressure for patients with glaucoma. Before taking any step, you should consult your physician.
During pregnancy, don’t forget to tell your doctor as Fluoroscopy x-rays may not be good for the baby.
What happens post injection?
It takes 1-3 days for the steroid to work. But in some cases, it takes a week to feel the benefits. Generally, steroids are well tolerable. However, some may experience the side effects. These effects are flushing of the face and chest that can last several days, anxiety, trouble sleeping, changes in menstrual cycle, or temporary water retention. But these effects are mild and can be resolved within a week.