Pain Therapy Injections: Epidural Steroid Injections

Epidural steroid injections are a form of pain therapy injection that have been used to relieve pain since the early 1950s. They are a nonsurgical treatment for lower back pain that radiates to the legs or neck pain that radiates to the arms.

How do Epidural Steroid Injections work?

When corticosteroid injections are administered into the space surrounding the spinal cord, the epidural space, they are referred to as epidural steroid injections. The corticosteroid, a synthetic hormone, decreases the body’s immune system at the injection site, relieving inflammation and pain in the area and potentially reducing the need for medication or surgical interventions.

What do Epidural Steroid Injections treat?

Epidural steroid injections may be effective to treat back or neck pain due to irritated nerves in the spine.

Nerves may become irritated due to conditions that compress or narrow the spinal canal, including:

  • Spondylosis
  • Spinal stenosis
  • Spondylolisthesis
  • Compression fractures
  • Degenerative disk disease
  • Scoliosis causing nerve irritation
  • Ligamentum flavum hypertrophy
  • Arthritis of the facet joints in the spine
  • Vertebral bone spurs compressing spinal nerves

How often are Epidural Steroid Injections given?

Although epidural steroid injections are generally effective, the pain relief may be temporary. Patients often require additional injections to maintain adequate pain relief.

However, the frequency of epidural steroid injections is typically limited to a few times a year. Corticosteroids can weaken the spine and surrounding muscles, and spacing injections allows the body’s hormone levels to return to normal between doses, reducing the risk of systemic side effects.

What are the potential complications of Epidural Steroid Injections?

Complications from epidural steroid injections are rare, but can include:

  • Infection 
  • Bleeding    
  • Nerve injuries
  • Allergic reaction 
  • Epidural abscess 
  • Cerebral infarction
  • Epidural hematoma 
  • Spinal cord infarction
  • Positional headaches
  • Back or lower extremity pain
  • Transient numbness or tingling in the limbs

Side effects may also occur due to the corticosteroid, such as:

  • Flushing or hot flashes
  • Elevated blood sugars
  • Fluid retention
  • Mood swings
  • Weight gain

Are there any contraindications for Epidural Steroid Injections?

Contraindications for epidural steroid injections include:

  • Significant allergies or hypersensitivities to contrast dyes, anesthetics, or corticosteroids
  • Local infection at the injection site
  • Anticoagulation therapy
  • Congestive heart failure
  • Uncontrolled diabetes
  • Systemic infections
  • Bleeding disorders
  • Local malignancy
  • Pregnancy

Conclusion

Epidural steroid injections offer an effective nonsurgical option for managing pain related to spinal conditions. While they can provide significant relief, the relief is generally temporary, and injections are limited to a few times a year. Careful consideration must be given to prevent side effects or complications from the injection or the steroid medication injected.

How do epidural steroid injections compare with other injection therapies for pain control? Check out our Summary and Comparison Chart.



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