An epidural steroid injection is a safe and effective treatment that can help alleviate pain in the lower back, leg, neck or arm.
An epidural injection can be administered in the back (lumbar epidural) or neck (cervical epidural), depending on your symptoms. Epidural steroid injections are safe to use on a variety conditions, including:
- Herniated Discs
- Low Back Pain
- Neck Pain
- Arm Pain or Numbness
- Spinal Stenosis
The injection provides much-needed pain relief and allows patients to return to normal activities.
Typical Benefits Of Epidural Steroid Injections
- Reduction in pain, stiffness, weakness, numbness or tingling.
- Improvement in function and mobility.
- Increased effectiveness of physical therapy or other strengthening program.
- Reduction in pain medication consumption.
- Reduction in inflammation.
- Avoidance of surgery.
Conditions Treated With Epidural Injections
Several conditions that cause pain from nerve inflammation can be successfully treated with epidural steroid injections, including:
- Sciatica – Pain and/or numbness that travels into the leg
- Lumbar or Cervical herniated discs
- Low back pain
- Lumbar or Cervical degenerative disc disease
- Neck Pain
- Pain, weakness or numbness in the shoulder, arm or hand
- Lumbar or Cervical spinal stenosis
Epidural Injection Procedures Explained
Epidural Injection Procedure – Lumbar Epidural and Cervical Epidural
A lumbar epidural is performed for low back pain, lumbar herniated discs or sciatica. A cervical epidural is performed for cervical herniated discs or neck pain that radiates into the arm.
An epidural steroid injection is a simple office based procedure. It typically takes 10 minutes, and there is no downtime after. It can be done with local anesthesia, or intravenous sedation for comfort if desired. It is generally not painful and well tolerated. During an epidural injection, a small needle is inserted into the epidural space with X-ray guidance (fluoroscopy). After proper placement of the needle is confirmed, an anti-inflammatory steroid medication is injected through the needle. This will decrease inflammation and swelling in the epidural space, which takes pressure off the nerves and soft tissues, and allows healing to begin. Some patients may feel better right away, but it generally takes a few days for inflammation to subside. Patients may return to work the same day or next day.
Transforaminal Epidural Steroid Injection Procedure for Sciatica
Transforaminal Epidural injection (TFESI) is a treatment option for patients suffering from sciatica and herniated discs. This procedure will help alleviate pain, numbness and weakness that typically travels into the leg. This procedure usually takes 10 minutes, and can be done with local anesthesia or intravenous sedation for comfort if requested. It is generally not painful and well tolerated. Using X-ray guidance (fluoroscopy), a small needle is placed into the epidural space near the inflamed nerve roots. After appropriate placement of the needle is confirmed by X-ray, a local anesthetic and an anti-inflammatory steroid medication is injected around the inflamed nerve roots. Some patients report immediate relief, but it typically takes a few days for inflammation to subside. Patients may return to work the same day or next day.
Dr. Mogilevsky performs a Transforaminal Epidural Injection for Sciatica
Frequently Asked Questions About The Epidural Steroid Injection Procedure
Is Cortisone Used For Epidural Steroid Injections?
Cortisone is an older steroid that is no longer commercially used. The term “cortisone” is now used to mean “corticosteroid”, which is a group of steroid medications that have anti-inflammatory properties. At Unique Pain Medicine, we use the corticosteroid Dexamethasone for epidural injections. Dexamethasone has an excellent safety profile, and produces fast, effective pain relief without unwanted side effects. It is the best available steroid for epidural injections.
What are the side effects of epidural steroid injections?
Side effects generally do not occur. When they do, they tend to be mild and easy to manage. Some possible side effects include temporary facial redness, mild sleep disturbances, menstrual changes, and elevated blood sugar in diabetics.
Are epidural steroid injections painful?
Epidural injections are generally minimally uncomfortable and very well tolerated. If you have a fear of needles or have severe pain, we do offer IV sedation which is administered by a board certified anesthesiologist. This will help you relax and make the procedure painless.
How often can epidural steroid injections be given?
Epidural injections can be given up to a maximum of 3 injections in a 6 month period, or a total of 4 injections in a 12 month period. It is safe to repeat the epidural injection 2 weeks later should it become necessary. For most patients, only 1 or 2 epidural injections is required for complete pain relief.
How long does it take before epidural steroid injection starts to work?
Epidural injections typically take 3-5 days to take full effect. There may be some immediate pain relief right after the procedure, but we advise patients to give the medications a few days to work for maximal results.
What are epidural steroid injections commonly used for?
Epidural injections are used to treat low back pain, sciatica, leg pain/weakness/numbness, neck pain, arm pain and/or numbness/tingling, herniated discs, lumbar radiculopathy and cervical radiculopathy and discogenic pain.
At what spinal level is an epidural steroid injection typically performed?
Lumbar epidural steroid injections are typically performed at the L5 – S1 level. If that space is fused, or if there is prior surgery at that level, an epidural may be performed at the L4 – L5 level. The spinal cord typically ends at L1 – L2 level, leaving a large margin for safety. Cervical epidural injections are typically done at the C7-T1 level.
Are epidural steroid injections safe?
Epidural injections are very safe. With highly experienced and knowledgeable physicians performing the procedure, serious complications are extremely rare. The most common possible complication is a headache, which occurs < 1% of the time.
How long do epidural injections last?
This will depend on your condition and the degree of nerve damage or inflammation. For some people, epidural injections last for many years. For others, 6-12 months. Epidural injections will not work for everyone. If epidural injections are not working and pain persists, you will be referred to a surgeon for consultation.
What can I expect after an epidural steroid injection?
You will rest in the recovery room and be monitored for 30 minutes after the procedure. There is usually no down time. The band aid can be removed the next day. You may feel better right away, or it can take a few days for the full effect. You can expect your pain to slowly subside, and you can increase your activity level.
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