Epidural Injections

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What is an Epidural?

Epidural injections are commonly known as a pain relief shots that pregnant women get while giving birth. However, the term epidural is simply a type of injection that goes in the epidural area of your spine. The epidural area is outside the membrane surrounding your spinal cord.

Inflammation-Reducing Epidural Steroid Injections

Many patients at the Laser Spine Center have benefited from Epidural Steroid Injections (ESIs) that help relieve inflammation related to radicular pain emanating either from the lower back into the legs and/or the neck into the shoulders and arms. ESIs reduce inflammation in your spinal nerves and give you relief from pain and pinched nerves.

What are Epidural Injections and How do They Work?

Inflammation within the spinal column often occurs due to a process called spinal stenosis which is a narrowing of the passage where your spinal cord resides. This can happen for various reasons such as disc herniations, bone spurs, thickening of spine ligaments, joint cysts, or abnormal vertebrae alignment (slipped discs).

The epidural space where the injection is applied is composed of fat which both surrounds and cushions your spinal cord and its nerve branches. We use a needle to deliver potent steroids that will reduce the inflammation resulting in diminished pain and improved function. While the steroids will interrupt the inflammatory cycle, they will not cure the underlying problem. However, the relief in pain will allow you time to make lifestyle adjustments and pursue things such as physical therapy or chiropractic that will improve your body’s strength and enable you to compensate for the condition.

Interlaminar ESI's

Interlaminar ESIs are injected from behind into the posterior portion of the spine.

Caudal ESI's

Caudal ESIs inject medication into the base of the tailbone and bathe the selected nerve roots.

Transforaminal ESI's

Transforaminal ESIs inject medication into the space next to the intervertebral disc and nerve root.

Epidurals for Back Pain

The benefit of using an epidural for back pain rather than more traditional oral medicine like pain killers is that it requires lower doses of medication, and thus has less side effects. The pain relief will even be longer lasting while staying mobile.

Epidural Procedure

Epidural injections start with an X-ray to guide the needle into the exact location. This location is picked to be as close to the nerve causing the pain as possible to get the maximum effectiveness of the medication. Many types of conditions can be treated with an epidural such as pinched nerves, radiating pain from the spine, herniated discs, and spinal stenosis.

The procedure itself takes only 15 minutes with the numbing effect being felt quickly. The steroidal part of the injection slowly begins to work over the next 2 to 5 days.

What to do after an epidural steroid injection?

Post operative care for an epidural steroid injection will be to ice the area if you feel mild soreness for 20 minutes at a time as needed. Also avoid heat at the injection site for 72 hours after the procedure.

How long do epidural injections last for back pain?

Epidural steroid injection is a pretty quick procedure with not many complications or risks. However, how long does the pain relief from an epidural injection last? The average length of time for pain relief from an ESI is about 3 months, which will give you time to perform exercises, and physical therapy that may allow your back to heal. They can also allow you to delay surgery since the epidural injections will reduce inflammation and relieve symptoms.

How painful is a lumbar epidural steroid injection?

ESI may seem daunting since you’ll have an injection into your back, so you might think it will be a painful procedure. However, before you get an injection you’ll have an anesthetic such as Lidocaine to reduce any pain from the actual injection itself. The anesthetic will numb the area so you won’t have much sensation at the injection site. Your doctor can sedate you before the procedure as well if you opt for that. If you’re having an ESI performed on an area that is inflamed and more sensitive you may still experience some slight pain. However, generally it’s not a very painful treatment.

Interlaminar epidural steroid injections

An interlaminar epidural steroid injection is very similar to a standard epidural injection. The main difference is the injection to the epidural space is directed between the laminae of two adjacent vertebrae. The benefits of this is that the medication can spread over a larger area than a transforaminal epidural injection and are beneficial for patients with multi-level spinal issues. Other than that the procedures are pretty much the same, and you can expect similar effects from the administered medicine.

Side effects of epidural steroid injections

The most common side effect from an epidural steroid injection is a headache that lasts a few days, or your pain may get worse before it gets better. Complications are rare, but they can include elevation of blood sugar, insomnia, bleeding into the spinal canal or infection.

If epidural injections don’t work what next?

If an ESI doesn’t deliver the expected pain relief or even if it does and you haven’t resolved the issue after it wears off in a few months, what do you do next? Depending on the condition being treated with an epidural injection your next steps may vary. For a herniated disc, for example, you can look at minimally invasive operations such as laser spine surgery, or an endoscopic discectomy. You could also try other pain management techniques such as radiofrequency ablation if you have spondylosis or arthritis of the spine. Physical therapy and chiropractic treatments are also usually recommended to rehabilitate the spine in most situations.

Epidural Steroid Injections

Call the Laser Spine Center today to make an appointment with one of our specialists to find out if an ESI is the proper treatment for your neck, back or joint problem.