Advanced Pain Management
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Epidural steroid injections are used to treat a variety of painful conditions involving the low/mild back and neck such as bulging discs, “pinched nerves”, arthritis, sciatica, etc. This type of injection has been performed for more than 50 years. Some of the advantages include:
Epidural steroid injections are usually used for ongoing painful conditions that have not responded to more conservative therapy such as physical therapy, anti-inflammatory medications, etc. although occasionally the injections are performed as a “first line” therapy in severely painful cases.
These injections are done in a series of three, although this is not always the case. Although it is not mandatory unless sedation will be given, please try to arrange for someone to drive you both to and from the appointment for your comfort. It is possible to have some numbness in an arm or leg after the injection making it difficult to operate a vehicle. If you are taking certain medications you may be advised to stop any blood thinners 7 days prior to the procedure or NSAIDS (i.e. Motrin, Ibuprofen, Advil, Aleve) 3 days prior to the procedure.
The injection is done with a thin needle after a local anesthetic is used to minimize pain. Sedation is available if the provider recommends it or upon request. The needle is guided into place using an x-ray unit (fluoroscope). After the needle is in place, a small volume of long acting steroid as well as some local anesthetic is administered into the epidural space. The medicine will bath the nerves, joints and discs of the back/neck. Generally it is thought that if inflammation can be eliminated and local blood flow can be restored then the pain will not return. The injections are done in a series to help decrease the inflammation to the lowest level of inflammation as much as possible, which requires multiple injections.
Possible side effects include slight pain/spasm at the injection site. Ice for the first 24 hours can be used to lessen any pain or spasm. Heat can be used after the first 24 hours. It is advised that you rest the remainder of the day and may return to normal activities the next day. You will be given specific post-injection instructions at the time of the injection. Other rare side effects include bleeding, infection and nerve damage.
The beneficial, pain relieving effects of epidural steroid injections can usually be felt anywhere from a few hours to a week after the injection. The pain could return somewhat, but not to pre-injection levels.
Nevertheless, published complications include bleeding, infection and inadvertent nerve damage.
Success rates vary from 60%-80% in the literature. Although the small nerves will be permanently destroyed it is likely that new nerves may grow back. However, most patients do not require a repeat RF procedure in the future. Overall pain relief will last anywhere from 34 months to permanently.
Possible side effects include slight pain/spasm at the injection site. Ice for the first 24 hours can be used to lessen any pain or spasm. Heat can be used after the first 24 hours. It is advised that you rest the remainder of the day and may return to normal activities the next day. You will be given specific post-injection instructions at the time of the injection. Other rare side effects include bleeding, infection and nerve damage.
The beneficial, pain relieving effects of epidural steroid injections can usually be felt anywhere from a few hours to a week after the injection. The pain could return somewhat, but not to pre-injection levels.
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