Epidural Steroid Injection

Epidural Steroid Injection

An epidural steroid injection is a common procedure to treat spinal nerve irritation. It is most often caused by tissue next to the nerve pressing against it. The beginning of the nerve root may be irritated by a bulging vertebral disc, disc contents from a ruptured disc or bone spur, precisely touching the spinal nerve.

An epidural steroid injection involves coating an inflamed nerve root in steroids, an anti-inflammation medicine, in order to reduce the irritation of the nerve root that is causing pain.

How it’s Done

 

During an injection, a needle and syringe are used to enter the epidural space and deposit small amounts of long-lasting steroids around the inflamed spinal nerve. A fluoroscope, an instrument used to view using X-rays, is used to visualize the local anatomy during the injection. The steroid injection specifically targets the locally inflamed area and treats it with a maximal amount of steroids, therefor minimizing exposure of the rest of the body to steroids.

When is an Epidural Steroid Injection Helpful?

They are most commonly used in situations of radicular pain, which is radiating pain that is transmitted away from the spine by an irritated spinal nerve. Irritation of a spinal nerve in the low back causes pain that goes down the leg.

Conditions that may benefit from an Epidural Steroid Injection:

  • Nerve compression in the neck
  • Degenerative disc disease
  • Lumbar spinal stenosis
  • Compression fractures
  • Annular tear
  • Herniated disc

Conditions that should avoid Epidural Steroid Injection:

  • Pregnancy
  • Bleeding problems
  • Local or systemic infections
  • Allergies to injected solution
  • Congestive heart failure

Frequency of Epidural Steroid Injection

Currently, there is no definitive research to indicate how many epidural steroid injections should be administered or how frequently they should be given. The consensus is to perform up to three epidural injections per year, which is about the frequency that many arthritis patients receive cortisone shots for shoulder and knee pain.

Some doctors may space the injections out evenly over a year, others take a different approach and administer two or three epidural steroid injections at 2-4 week intervals, if the first shot resulted in significant pain relief. If a patient does not experience any back pain or leg pain relief from the first injection, further injections may not be beneficial.

Possible side effects form Epidural Steroid Injection:

  • Localized increase in pain
  • Facial flushing
  • Anxiety
  • Fever the night of injection
  • Sleeplessness
  • High blood sugar

Success Rates

An epidural injection is generally successful in relieving lower back pain for approximately 50% of patients. While the effects of the injection tend to be temporary (one week to one year), an epidural can be very beneficial in providing relief for patients during an episode of severe pain.

Dr. Dumitru is a board certified and fellowship trained pain management specialist. To learn more, or to schedule an appointment please call (713) 461-8555.

About the author...

Adrian C. Dumitru, M.D., began his 27-year journey toward mastering the complexities of pain management by becoming an anesthesiologist. In pain management, a field where everyone from family therapists to general practitioners often participate, Dr. Dumitru saw the need for a physician with his particular expertise to oversee a multi-disciplinary approach.

View All By Dr. Adrian Dumitru