How does epidural steroid injections work

After the first series of three injections, you would need to wait at least 6 months to a year before you could have more. It is very difficult to predict how helpful injections will be. Overall, this procedure has very few risks. However, as with any procedure, there are some risks and side effects you should know about. Side effects of the injected steroid are generally temporary and may include feeling sweaty and red faced for a few days, temporary weight gain, a short term increase in blood sugar mainly in diabetics if you take medication for diabetes your doctor may need to advise you about medication adjustment, you can discuss the steroid medication more completely when you come in for the procedure.

The following patients should not have this injection: if you are allergic to any of the medications to be injected, if you are on a blood-thinning medication e. Coumadin, injectable Heparin , or if you have an active infection going on. Anti-platelet drugs like Plavix may have to be stopped for days prior to the procedure. Aspirin should be stopped for cervical procedures for 10 days prior, but not for Lumbar.

What is an epidural steroid injection? Why is it done? How long does it take to do? What medicines are injected? Will it hurt? How is it done? What should I expect after the injection? What should I do after the procedure? Can I go to work the same day or the next day? How long does it last? How many injections do I need to have?

Most people who suffer with back pain already know the drill: time heals this wound. Over weeks to months, the pain will calm down, and you will slowly return to your normal life.

In the meantime, try to stay as active as possible and rely as much as possible on over-the-counter pain relievers to help avoid needing cortisone shots. Doctors call these shots corticosteroid injections. But for some, these conservative measures may not relieve the agony soon enough—especially if the problem is back pain caused by irritated spinal nerves. After a few weeks, just getting to the bathroom may start to feel like Napoleon's winter march in Russia.

At that point, you may be offered a cortisone injection to calm the war zone in your lower back. Even for nerve-related back pain, guidelines discourage hasty intervention with cortisone shots. However, if you choose to take a cortisone shot, know its limits. Shmerling says. Used appropriately, cortisone shots can calm inflamed joints and tissues but do not speed healing or prevent future problems.

Here are some of the most common targets for corticosteroid injection therapy:. Cortisone shots are not for ordinary strain-and-sprain backaches. Orthopedic specialists usually offer them for shooting nerve pain sciatica from a ruptured disk, or symptoms associated with narrowing of the space around the spinal cord spinal stenosis.

Even for nerve-related back pain, try the conservative route first, because steroid shots come with risks. Conservative therapy includes the following:. How long should you wait before considering injection therapy? It depends on the intensity of the pain and how long you can bear it before it starts to ease on its own. Most men experience substantial improvement within six to eight weeks. Steroid injections contain various formulations of medications. A common combination is a numbing drug similar to procaine Novocain mixed with the anti-inflammatory drug cortisone.

Once the cortisone injection finds its target, the numbing effect will start to wear off within hours. If the cortisone shot works, you'll certainly be grateful for the relief, but success is not guaranteed.

In studies of large groups of back pain sufferers, the benefit is small to none on average. Dexamethasone is an example of non-particulate steroids. While some injection preparations use pure steroids, others mix local anesthetics in the steroid solution for enhanced pain relief. Local anesthetics act relatively faster than steroids and help reduce pain signals from inflamed nerves. Typically, 1 of 3 techniques are used in an epidural steroid injection: transforaminal, interlaminar, and caudal.

Each method fills the epidural space differently and deposits the medication in a different location within the space. The effectiveness of a technique depends on its ability to deliver the medication closer to the target nerve roots. This method is considered the most effective in depositing the solution close to the affected nerve roots. It may be used if sciatica is caused by certain lower back conditions, such as a lumbar herniated disc impinging a spinal nerve. In this method, the needle is inserted through the side of the spinal canal into the intervertebral foramen to reach the epidural space.

To avoid adjacent blood vessel damage, the needle is passed through a small space above the spinal nerve as it exits the neuroforamen, called the safe triangle. In this method, the needle is inserted through the back of the spinal canal between adjacent spinous processes bony projection of the vertebra or laminae posterior wall of the vertebra to reach the epidural space. In this technique, the needle is inserted from below the spinal canal through an opening called the sacral hiatus.

The depth of penetration of the needle to reach the epidural space is more in this method. While this method is safer and easier to perform, it is also less effective. View the various techniques used in an epidural steroid injection: Transforaminal, Interlaminar and Caudal.

In general, the location and severity of the spinal inflammation, injection technique used, and the proximity of the medication to the affected nerve roots—all contribute to the final outcome of the injection.