Epidural Spinal Injections for Back Pain
Epidural steroid injection offers the potential of pain relief to people with neck, mid-back and lower back pain with or without arm or leg pain. Two different routes of administration are available for steroid placement within the epidural space: transforaminal, or the area of exiting nerve from the spinal cord, and interlaminar, or the area behind the spinal canal.
In the neck area of the spine, interlaminar injection is generally considered safe with reports of minor complication rate of less than one percent. In the lower back area, interlaminar injection is considered safe with low complication rates nationally.
The pain management physicians at the Pain Relief Centers complete all procedures with the benefit of x-ray guidance. Blinded epidurals (those done without x-ray guidance) have shown the greatest risk and less positive outcomes than epidurals done using fluoroscopy. Blinded epidurals are done with the assumption the injected steroids will spread to the sites of pathology. Studies of epidural steroid injections without x-ray guidance show the injected medications fail to reach the target site at a significant rate with a consequent lack of benefit. There was also an increased risk and a potential increased incidence of surgery.
Epidural steroid injections (ESI’s) are primarily used to relieve pain from a mechanical irritation or inflammation that affects the nerves leaving the spinal cord to the arms and legs. This procedure targets specific administration of steroids to help suppress the inflammation caused by discs which have herniated, protruded, torn or have been disrupted by other causes.
Other indications for epidural steroid injections include pain from herpetic neuralgia and a multitude of arthritic changes, such as spinal stenosis.
Epidural steroids injections may be repeated if partial improvement occurs. Repeated injections are not recommended if there was either no relief or full relief after the procedure.
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