Epidural Steroid Injections

Epidural steroid injections are aimed at alleviating inflammation and painful symptoms associated with chronic conditions of vertebral discs that originate in the spine. Damaged or herniated discs often cause irritation or compression of spinal nerve roots, leading to painful swelling. By reducing inflammation in the epidural space, where nerve roots may be compressed and result in back pain and nerve malfunction; the injections can be an effective type of pain management. They can be utilized as a standalone therapy or employed to ease pain adequately for a patient to exercise effectively during physical therapy sessions.

The source of pain can arise from discs located in one of the three general regions of the spine: the cervical region (upper back/neck area), thoracic region (mid-back area), or lumbar region (lower-back area). To address problems originating in each of these regions, three distinct types of epidural steroid injections are employed.

Who is A Good Candidate For A Tesi?

If you have been dealing with sharp mid-back pain that radiates and conservative treatments such as physical therapy, over-the-counter medications, and RICE haven't worked for you, then you may be eligible for a TESI. A physician will conduct a thorough history and physical examination during your consultation, as well as examine any diagnostic imaging to determine if a TESI would be beneficial for you.

Benefits Of Lower Back Steroid Injections

Epidural steroid injections have been utilized in the management of lower back issues since 1952 and continue to be an essential component of non-surgical treatment for sciatica and lower back pain. Unlike oral pain medications and steroids, epidural injections directly target the site of pain, providing targeted medication delivery.

Lower back, or lumbar, steroid injections work by:

  • The surgeon will inject a steroid, or cortisone as an anti-inflammatory agent.
  • Lidocaine is a temporary pain relief option. In addition to its pain-relieving properties, it also serves as a "flushing" agent by diluting inflammatory chemicals or immunological agents.
  • The local anesthetic is diluted by saline. In some cases, a ‘flushing’ agent is used to dilute the inflammatory chemical or immunologic agents.
  • Administering a lumbar epidural steroid injection (ESI) can serve both as a diagnostic tool and a treatment option for nerve root problems. By injecting numbing medication into the affected area, we can assess the level of immediate pain relief you experience. If the pain dissipates entirely or significantly, it confirms the root of the pain. In addition to the instant relief provided by the numbing agent, the steroid component can help reduce inflammation, providing long-term pain relief.

The following conditions are treated by lumbar ESI:

  • Lumbar spinal stenosis
  • Lumbar disc herniation
  • Degenerative disc disease
  • Annular tear in the outer layer of the disc
  • Compression fractures in a vertebra
  • Cysts on the facet joint or the nerve root that can expand and squeeze spinal structures

It usually takes 2-3 days for steroids to start working. In some cases, it may even take as long as one week for the results to be visible. You can return to work the day after the procedure.

In case, you have been suffering from lower back pain or sciatica, get in touch with our team at Neuro Spine & Pain Center. At our medical center located in Miami's Key West, we provide various interventional treatments, including lumbar epidural steroid injections.

Are there any side effects?

Usually, epidural injections are well-tolerated and produce minimal side effects. Any discomfort experienced at the injection site is usually short-lived and resolves within a few hours. Although rare, medication side effects are possible due to the corticosteroid injection. Patients with known allergies to medications will have this concern discussed prior to the procedure to prevent unwanted reactions. Any residual pain near the injection site can be managed with over-the-counter pain relievers or an ice pack. Most patients are able to resume their normal activities, including work, the day after the procedure.

How are epidural steroid injections performed?

Epidural steroid injections are conducted on an outpatient basis using local anesthetics to numb the injection area, occasionally in conjunction with light sedation to alleviate patient anxiety. A special X-ray is used to direct needle insertion into the epidural space after thorough cleansing of the injection site. The needle is withdrawn after medication injection, and a small bandage is applied over the injection area. Following a short stay in a recovery area, patients are discharged, and most are able to return to their normal routine the following day. Symptom relief typically appears within one to three days following the procedure.

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