What are epidural steroid injections? What steroids are used? Who can benefit from them? How do they work? Learn the answers to these and more in this in-depth guide.

Understanding Epidural Steroid Injections

Epidural steroid injections are a common treatment for various spinal conditions that cause back, neck, and radiating pain. These injections involve the delivery of corticosteroid medication directly into the epidural space surrounding the spinal nerves. The epidural space is the area between the protective covering of the spinal cord (dura mater) and the vertebral canal.

What Are Epidural Steroid Injections Used For?

Epidural steroid injections are primarily used to treat back pain and radiating pain caused by a variety of spinal conditions, including:

• Herniated or bulging disc
• Degenerative disc disease
• Lumbar or cervical radiculopathy
• Spinal stenosis
• Sciatica
• Postherpetic neuralgia
• Facet or synovial cysts

What Steroids Are Used?

The most commonly used steroids in epidural injections are:

• Dexamethasone
• Betamethasone
• Methylprednisolone
• Triamcinolone

The choice of steroid and dosage is based on various patient factors, response to prior injections, the specific spinal region being treated, and the injection approach.

How Do Epidural Steroid Injections Work?

Epidural steroid injections work by delivering a potent anti-inflammatory medication directly to the site of nerve irritation or compression in the spine. The injected solution, which may also include local anesthetics and saline, aims to reduce inflammation and swelling around the affected nerve, thereby alleviating pain and other symptoms.

These injections are typically performed under fluoroscopic or X-ray guidance to ensure the accurate placement of the medication within the epidural space. In some cases, CT or ultrasound guidance may be used instead.

Who Can Benefit from Epidural Steroid Injections?

Patients with various spinal conditions, such as those listed earlier, may benefit from epidural steroid injections. These injections can be an effective non-surgical treatment or may assist in surgical planning for some patients.

The decision to recommend epidural steroid injections is based on the individual’s diagnosis, symptom severity, and response to other conservative treatments.

How Often Can You Get Epidural Steroid Injections?

Epidural steroid injections are typically recommended to be administered up to three to six times per year. In cases of a new disc herniation, the injections may be performed more frequently, such as a few weeks apart, with the goal of quickly resolving the symptoms.

For chronic spinal conditions, the interval between injections is often three to six months or more, depending on the patient’s response and the persistence of symptoms.

What Are the Risks and Side Effects?

Epidural steroid injections are generally considered safe, but like any medical procedure, they do carry some risks, including:

• Infection
• Bleeding or bruising
• Headache
• Temporary increase in pain
• Allergic reaction to the injected medications
• Potential side effects associated with corticosteroids, such as elevated blood sugar levels or adrenal suppression

Patients should discuss the potential risks and benefits with their healthcare provider before undergoing this procedure.

Preparing for the Procedure

Prior to the epidural steroid injection, patients may be asked to:

• Discontinue certain medications, such as blood thinners, for a specified period
• Undergo diagnostic imaging, such as an MRI or CT scan, to confirm the underlying condition
• Arrange for transportation, as they may not be able to drive immediately after the procedure

The procedure itself is typically performed under local anesthesia, and patients may experience some discomfort during the injection, but it is generally well-tolerated.

Conclusion

Epidural steroid injections are a common and effective treatment option for various spinal conditions that cause back, neck, and radiating pain. By delivering anti-inflammatory medication directly to the affected area, these injections can provide relief and aid in the management of chronic spinal conditions.

Patients should discuss the potential benefits and risks with their healthcare provider to determine if epidural steroid injections are an appropriate treatment for their specific condition and circumstances.