Epidural Steroid Injections for Back Pain
While many people may experience back pain at some point in their lives, most will never need anything more than conservative treatments to deal with the pain. This includes over-the-counter medication, massage and chiropractic treatment coupled with short-term rest. There are those who are experiencing back pain as a result of a more serious condition such as a pinched nerve that will not be relieved by conservative treatments. In these cases, steroidal injections may be an option.
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Epidural Steroid Injection Definition
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An epidural steroid injection is a shot administered directly into the nerve being affected by the injury. It is often a corticosteroid such as cortisone that is designed for pain management and swelling reduction. An epidural steroid injection delivers steroidal substances that mimic the body's natural steroid hormones, cortisone and hydrocortisone, directly to the area experiencing the pain .
Effectiveness
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The administration of the steroid reduces swelling and irritation on the nerve. This helps to reduce pain. The problem is that this is a temporary solution. While each person will experience different results, you can expect to have relief last anywhere from several weeks to a couple of months. Some patients will get more than one shot within a year but do so risking other potential problems. Doctors are typically cautious and limit the number of injections a person can receive annually.
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Limiting Injections
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Jerry W. Swanson, M.D., of the Mayo Clinic explains that epidural steroid injections for the back are limited to three annually because there are potentially serious side effects. These include a decreased bone density in the area of the injection, skin thinning, muscle weakness and a reduction in the body's production of its own steroids. These side effects can lead to further injury and degenerative issues in the back, creating larger long-term issues.
The Procedure
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You will want to have a ride to and from the hospital when you get an epidural injection. Having help with household chores afterward so you can avoid a lot of bending and stretching will also help you recover more quickly. Make sure your doctor is aware of any medications, vitamins and supplements you are taking, especially blood-thinning drugs. The procedure is performed with you lying on your abdomen. The area of the injection will be cleaned with alcohol and a topical anesthetic will be applied. A needle will be guided between the bones and ligaments of the spine while your doctor uses an X-ray to see where it is going. Once in the epidural space, a hard membrane that envelops the spinal cord and the brain, your doctor will administer the steroid. This is approximately a 20-minute process and you will be monitored for a similar amount of time before being released.
Procedure Risks
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Aside from the risks of having too many steroid injections, the procedure itself carries its own level of risk. This is, after all, an injection into your spinal column. While complications are rare, you should be aware of them. You may experience a headache, have an allergy to the anesthetic or an allergy to the steroid. Additionally, infection is a possibility, as is nerve damage if the needle intrudes into the wrong section.
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