Epidural steroid injections (ESIs) are a standout amongst the most widely recognized methods used for pain that originates in the lumbar (low back) or cervical (neck) spine, sometimes in the thoracic (mid back). When done by an experienced, well accomplished physician, ESIs are secure and effective for some of the most common types of pain. We’ll talk a little about ESIs today, however, remember this isn’t a comprehensive coverage of ESIs, and your specific circumstances ought to be examined with your doctor before you settle on a choice on whether the procedure is appropriate for you.
First, a little bit about the spine. The bones of the spine look almost like closed padlocks that are laid flat and stacked up on each other. There are squishy cushions (the disks) between the bodies of the padlocks, and the spinal cord runs through the stacked-up loops of the padlocks. Large nerves leave the spinal cord, exiting the spine through the spaces between the padlock loops. These large nerves travel to specific parts of the body, in a fairly predictable pattern.
Got the general picture? Now imagine that one of the squishy cushions gets a little flat and starts to bulge out, or develops a bubble on it that protrudes out, or even gets a little rip in it so that the jelly inside the cushion starts to leak out a little. And imagine that the bulge or protrusion or leaked material starts to push on the spinal cord, or on one of the large nerves leaving the spinal cord. It turns out that when this happens it can be really painful, and the pain is perceived as running along all or part of where the large nerve runs.
Epidural steroid injections are used to put a steroid medication and a local anesthetic around where the nerve is irritated, with the intent of calming the area, reducing inflammation, and opening things up a little, so the nerve can function more normally. ESIs do not fix the disk (sometimes the body will do that, but it can take months or years), but the procedure can reduce pain, and sometimes reduce numbness, pins-and-needles sensations, and tingling. There is a lot of research indicating that ESIs can provide relief for weeks or months, with minimal risks, and may allow people to avoid having back surgery.
The potential risks associated with inserting the needle include spinal headache from a dural puncture, bleeding, infection, allergic reaction, and nerve damage / paralysis (rare). Corticosteroid side effects may cause weight gain, water retention, flushing (hot flashes), mood swings or insomnia, and elevated blood sugar levels in people with diabetes. Any numbness or mild muscle weakness usually resolves within 8 hours in the affected arm or leg (similar to the facial numbness experienced after dental work). Patients who are being treated for chronic conditions (e.g., heart disease, diabetes, rheumatoid arthritis) or those who cannot temporarily discontinue anti-clotting medications should consult their personal physician for a risk assessment. Overall, this is a very safe procedure if it’s carried out appropriately.
Sounds great, right? Choose your doctor effectively. Confused about who to contact? And what’s the best treatment for your pain? Contact Dr. Zaki Anwar! Dr Zaki is very experienced in interventional treatments. He is a world renowned Pain Medicine Physician and has been practicing ways to cure pain leading to serious problems for the past several years and has achieved remarkable results. Get his expert opinion by just making a phone call at 815-464-7212