What is an epidural steroid injection?
An epidural steroid injection is a common procedure to treat spinal nerve irritation that is most often caused by tissues next to the nerve pressing against it. The beginning of the nerve (nerve root) may be irritated by a bulging intervertebral disc, disc contents ("ruptured disc") or bone spur, directly touching the spinal nerve.
An epidural steroid injection involves bathing an inflamed nerve root in steroids (potent anti-inflammation medicine) in order to decrease the irritation of the nerve root that is causing pain.
What specialties of doctors administer epidural steroid injections?
Specialists who administer epidural steroid injections include anesthesiologists and pain-management specialists.
How is an epidural steroid injection performed?
The epidural steroid injection procedure is quick and simple. While it is common for people to be concerned prior to the procedure, it is actually frequent to hear from patients afterwards: "Is that all?"
The spinal cord rests in the spinal canal. The nerve roots branch out from the spinal cord at each level of a spinal vertebra (the bony building blocks of the spine). The cord is protected by cerebrospinal fluid (CSF), which serves as a shock absorber for the cord. The CSF is held in place by a membrane with several layers, one of which is called the dura, from the Greek for tough (think of "durable"). The Greek word "epi" means "outside of." So, the epidural space is outside of this tough membrane. During an epidural steroid 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 (a viewing instrument using X-rays) is used to visualize the local anatomy during the injection. The epidural steroid injection specifically targets the locally inflamed area and treats it with a maximal amount of steroids, thereby minimizing exposure of the rest of the body to the steroids.
When are epidural steroid injections used?
Epidural steroid injections are most commonly used in situations of radicular pain, which is a radiating pain that is transmitted away from the spine by an irritated spinal nerve. Irritation of a spinal nerve in the low back (lumbar radiculopathy), such as from lumbar spinal stenosis, cervical spinal stenosis, herniated disc, and foraminal encroachment, causes back pain that goes down the leg. Epidural injection is also used as a minimally invasive procedure to treat nerve compression in the neck (cervical spine), referred to as cervical radiculopathy, which causes pain.
SLIDESHOW
Lower Back Pain: Symptoms, Stretches, Exercise for Pain Relief See SlideshowWhat complications or side effects may be associated with epidural steroid injections?
Complications of epidural steroid injections include elevation of blood sugar (glucose), insomnia, bleeding into the spinal canal, and rarely, bacterial or fungal infection in the spinal canal.
What is the recovery time for an epidural steroid injection?
Recovery from an epidural steroid injection is typically within hours of the injection. If anesthetic is administered with the steroid, there can be hours of residual numbness of the nerves that were anesthetized.
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Discogram (Discography)
As we age, or become injured, the vertebral discs can become damaged and/or shrink, which causes pain. A discogram is used to determine if a particular vertebral disc is the source of pain. Discograms attempt to reproduce rather than remove pain to help determine if injury to a particular disc is the source of a person's pain. The information gathered from the discogram can lead to the diagnosis of a particular disc injury so the doctor can determine treatment options for relief of the pain.
Gluteal Injury
Falls or blows are the most common cause of gluteal injuries. Symptoms and signs of a gluteal injury include swelling, inflammation, bleeding, and redness. Treatment options may incorporate ice application, elevation, rest, physical therapy, and on occasion, surgery.
Herniated Disc
A herniated disc may be caused by injury or degeneration from age. Symptoms depend on the location of the herniation and whether nerve tissue is being irritated. An MRI or CT scan is performed to diagnose a herniated disc. Treatment may involve physical therapy, cortisone injection, pain medications, anti-inflammatory medications, muscle relaxants, and surgery.
How Long Does an Epidural Nerve Block Last?
An epidural nerve block is a procedure to block pain by injecting anesthetic medication into the epidural space of the spine. The procedure numbs the relevant nerve region thereby blocking the transmission of pain signals from those nerves to the brain. An epidural nerve block may be administered in the cervical, thoracic, lumbar or the caudal (lowermost) region of the spinal column.
Lower Back Pain (Lumbar Spine Pain)
There are many causes of back pain. Pain in the low back can relate to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis, and abdomen, and the skin covering the lumbar area.
Neck Pain (Cervical Pain)
Neck pain (cervical pain, cervicalgia) may be caused by any number of disorders and diseases. Tenderness is another symptom of neck pain. Though treatment for neck pain really depends upon the cause, treatment typically may involve heat/ice application, traction, physical therapy, cortisone injection, topical anesthetic creams, and muscle relaxants.
Pain Management
Pain management and treatment can be simple or complex, according to its cause. There are two basic types of pain, nociceptive pain and neuropathic pain. Some causes of neuropathic pain include:- complex regional pain syndrome,
- interstitial cystitis,
- and irritable bowel syndrome.
Pinched Nerve
A pinched nerve causes pain, numbness, or tingling in the affected area due to pressure on a nerve. Carpal tunnel and sciatica are two examples of conditions caused by a pinched nerve. A pinched nerve is diagnosed by taking a patient history and performing a physical examination. Electromyography may be performed. Treatment for a pinched nerve depends on the underlying cause.
Cervical Radiculopathy
Radiculopathy, a condition in which a nerve or nerves along the spine are compressed causing pain, numbness, weakenss, and tingling along the nerve(s). Some causes of radiculopathy include- bone spurs,
- disc hernation,
- osteoarthritis,
- tumors,
- infection,
- and neuropathy.
- cervical radiculopathy,
- lumbar radiculopathy,
- and thoracic radiculopathy.
Slipped Disc Picture
Rupturing of the tissue that separates the vertebral bones of the spinal column. See a picture of Slipped Disc and learn more about the health topic.
What Is an Epidural Nerve Block?
An epidural nerve block is a procedure to block pain by injecting anesthetic medication into the epidural space. The epidural space is the area between the inner wall of the backbone (vertebral column) and the outermost of the three membranes (dura mater) that surround the spinal cord.