Epidural Injections for Back Pain
When you are experiencing back pain that cannot be alleviated by ibuprofen, massage or other conservative means, the thought of a cortisone shot can sound heavenly. But these shots are not for all back pain and come with their own levels of risk. You should consult with your doctor about all the risks and keep them in perspective with the short-term benefits of these shots.
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Epirdural Injection Basics
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An epidural steroid injection is a shot usually composed of cortisone in the area that surrounds the spinal cord. This area is called the epidural space and is the location where the nerves stem out of the spinal cord. When there is an injury or irritation to this area, an epidural steroid injection will be used to reduce swelling and alleviate pain.
Procedure
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If you are having an epidural steroid injection, expect the procedure to last approximately 20 minutes. Your vital signs will be monitored for another 20 minutes after the procedure. The injection is done while you lie on your stomach. A local anesthetic is applied and the needle is inserted and guided between the vertebrae and ligaments to reach the epidural space. Your doctor will use an X-ray to help navigate to the correct area. Once at the point of nerve irritation or injury, the steroid will be injected.
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Benefits
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The benefits to an epidural steroid injection is that your body is given a boost of medication that mimics its own steroidal hormones, cortisone and hydrocortisone. When given a a dosage of steroids, this helps knock down swelling at the root of the problem and alleviate pain resulting from it. This includes any shooting pain, numbness or tingling that occurs from nerve irritation. Recovery is quick, though you will want to have a ride to and from the doctor's office.
Complications
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Complications are rare with epidural steroid injections but still need to be considered. One of the more common complications is a headache resulting from a "wet tap." This is a complication in which the needle inadvertently bumps the epidural wall and leaks cerebrospinal fluid. You may also have an allergic reaction to the anesthetic or the steroid itself. Bleeding and infection are other concerns that you need to be aware of. In rare instances, nerve damage may occur, causing temporary or permanent paralysis of affected muscles or extremities.
Short-Term Relief
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An epidural steroid injection is a temporary relief of symptoms. Most shots last from two to six weeks. Doctors will not give you a steroid injection into the same afflicted area more than three times per year. While there is much research that still needs to be conducted on this issue, the long-term degenerative effects of multiple shots may be a larger problem than the actual injury. Frequent shots may cause a thinning of the skin and lessen bone density. This may lead to degenerative issues that cause greater nerve problems down the road. In addition, as you provide the body with more steroids it can stop producing its own supply, becoming dependent on the injections.
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