You’ve tried everything, but medications and physical therapy aren’t enough to alleviate your back pain.
If you’re dealing with persistent nerve pain in your spine, your doctor may recommend an epidural steroid injection to treat your pain. Here’s what you need to know about this treatment option and how you can prepare for your procedure.
What Is an Epidural Steroid Injection?
An epidural steroid injection is a treatment for chronic back pain. A shot of cortisone is injected into the outermost section of the spinal column, the epidural space.
Cortisone is a type of steroid that occurs naturally in the human body, typically as part of our brain’s chemical response to stress. When the adrenal gland releases it, cortisone suppresses the immune system, dimming inflammation and, in turn, our perception of pain.
Naturally-occurring cortisone is short-acting. Artificial cortisone, like that delivered in an epidural steroid injection, is designed to last for much longer–anywhere from a few weeks to months.
How Does It Work?
The immune system is basically our body’s built-in defense system. It’s designed to fight against invaders, from bacteria to unknown viruses. So if you’re injured or something in your body isn’t working, your immune system is the first one on the scene, so to speak.
The immune system’s first response is inflammation. The goal is to kill off as much bacteria as it can around the damaged site before it needs to call in reinforcements.
Of course, your body isn’t meant to stay in a state of inflammation for an extended period of time–it’s a temporary measure until your immune system has moved on. So if the inflammation goes on for an extended period of time, it causes pain.
When cortisone is released by the adrenal gland, it has the opposite effect–it suppresses the immune system in a targeted area, reducing inflammation and thus reducing the associated pain.
When you get an epidural steroid injection, you’re taking advantage of naturally-occurring processes in the body. But instead of waiting for the cortisone to release on its own, your doctor is giving you a concentrated dose of artificial cortisone to hold the pain at bay for an extended period of time.
What Is it Used For?
Epidural steroid injections contains cortisone that acts as an anti-inflammatory agent. It creates an overall pain-relieving effect for an extended period.
This type of treatment is typically recommended for nerve pain in the spine, including:
What Are the Risks of Epidural Injections?
Generally, epidurals do not cause any ill effects. However, there are occasionally complications.
When side effects do arise, a few common ones include:
- Sleeping problems
- Steroid flush, or a rise in body temperature and flushing in the face and chest for several days
- Water retention
- Menstrual changes
- Increased hunger for a short peroid of time
Another common risk is the accidental puncture of the dura mater, the tissue surrounding the spinal cord. When this happens, spinal fluid leaks out of the spinal cord, creating a spinal headache.
As the name implies, it’s an extremely intense headache that gets worse when you stand or sit and lessens when you lie down. The pain can range from a dull, mild throbbing to an incapacitating pain similar to a migraine.
These headaches typically get worse before they get better. The good news is that they don’t tend to last longer than a few days.
What to Expect
If you and your doctor decide that the procedure is the right option for you, it’s important to understand what you should expect.
Before the procedure, your doctor will speak with you about your medical history, any current medications, allergies, and potential risks associated with the injection. If you are pregnant, nursing, or plan to be pregnant in the near future, make sure to tell your doctor.
The doctor will also review any pre-operation preparations necessary.
You won’t be able to drive after the procedure, so you should arrange for someone to drive with you and drive you back. Wear comfortable clothing and bring something along to occupy your time while you wait.
The skin around the injection site will be cleaned with an antiseptic and the doctor will inject a local anesthetic to numb the skin and deeper tissues or may spray a “cold spray” on your skin to numb prior placing the needle.
You will lie down on an X-ray table. The procedure will cause some discomfort. With a local anesthetic, you’ll feel a strong pressure, but you shouldn’t feel much pain.
Using fluoroscopy (a form of live X-ray) as guidance, your doctor will insert the needle and direct it toward the epidural space. Then, he will slowly release the cortisone and numbing medication.
The full benefit of the steroids will take a few days to take effect but shouldn’t take longer than five to seven days. Keep in mind that every patient is different.
If your symptoms are unchanged after a week, your doctor will investigate other potential sources of your pain. If the pain lessens but only for a short time, your doctor may suggest additional injections.
Do You Need Epidural Steroid Injections?
If you believe an epidural steroid injection might be the right choice to treat your back pain, we can help you.
NWA Interventional Pain is a comprehensive pain clinic offering solutions to your chronic pain. We individually tailor your treatment plan to ensure that we treat your pain in the manner that is best for you.
If you’d like to speak with us about your treatment options, use our contact page to get in touch.