What Are Epidural Steroid Injections
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What Are Epidural Steroid Injections?
Summary
Epidural steroid injections (ESIs) are long-lasting injections of cortisone administered into the epidural space surrounding the spinal cord and nerves. They are used to alleviate severe back pain, reduce inflammation and swelling of the nerves, and address symptoms like pain, tingling, and numbness. These injections are also referred to as spinal injections.
Article Body
Epidural steroid injections are powerful treatments designed to address severe back pain caused by nerve inflammation and irritation. By targeting the epidural space?"the area encasing the spinal cord and nerves?"these injections help reduce pain and swelling.
Originally introduced in 1952 to manage lower back pain associated with sciatica, epidural steroid injections have become a popular non-surgical option. They consist of a combination of local anesthetics, such as lidocaine or bupivacaine, and steroid medications like triamcinolone (Aristocort) or methylprednisolone (Depo-Medrol, Celestone-Soluspan).
These injections are particularly effective for managing acute or chronic lower back and leg pain resulting from conditions like lumbar disc herniation, degenerative disc disease, and lumbar spinal stenosis.
The procedure is performed with the patient lying flat on an X-ray table, and the skin is numbed using lidocaine, similar to novocaine used by dentists. Post-injection, patients might experience temporary heaviness or numbness in the legs, necessitating monitoring for 15 to 20 minutes using EKGs, blood pressure cuffs, and blood oxygen devices.
While the immediate effects of the anesthetic wear off in a few hours, the steroids generally take about three to five days to start working, with effects lasting several days to months. If relief isn't achieved within a week or two, additional injections may be recommended, with a maximum of three injections every six months.
Despite their benefits, epidural steroid injections carry some risks, including potential spinal puncture leading to headaches, infections, bleeding within the epidural space causing nerve damage, and symptom exacerbation. Side effects of cortisone can include weight gain, elevated blood sugar (particularly in diabetics), water retention, and suppressed natural cortisone production in the body.
Overall, while effective for many, it's essential to consider these risks and consult with a healthcare provider to determine if epidural steroid injections are appropriate for your specific condition.
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