Epidural Steroid Injection
An epidural steroid injection, also known as a spinal steroid injection, is a highly effective, non-invasive solution for managing chronic pain.
Commonly used to alleviate pain and reduce swelling associated with herniated discs, spinal stenosis, and sciatica, this treatment targets inflammation to provide long-lasting relief.
While risks exist, such as the potential for a blood clot, these risks are significantly lower compared to those associated with surgical procedures. By choosing non-invasive techniques, patients can experience pain relief with fewer complications.
At Bux Pain Management, led by Dr. Anjum Bux, a board-certified anesthesiologist who specializes in pain management, our dedicated team of experts is committed to helping you regain control of your life. We provide a range of advanced pain management solutions to meet your needs and ensure your comfort.
Trust Bux Pain Management to guide you on your journey to a pain-free life.
What Are Epidural Steroid Injections?
Epidural steroid injections (ESIs) are a minimally invasive and long-term pain treatment option for individuals suffering from chronic back pain. The epidural injection procedure involves administering anti-inflammatory medication directly to the region surrounding the spine, spinal nerves, and nearby blood vessels. The medication, delivered via a syringe, typically includes epidural anesthesia and corticosteroids, targeting the area around the lumbar spine. The exact injection site is carefully selected based on the patient’s specific pain source.
ESIs work by reducing inflammation and nerve sensitivity, providing relief from pain caused by lumbar conditions such as herniated disks, slipped vertebrae, joint cysts, bone spurs, and sciatica. By addressing inflammation in the affected area, the injection helps to reduce disruptive pain and restore function, offering patients a solution for chronic back pain without the need for surgery.
Why Consider Epidural Steroid Injections?
An epidural corticosteroid injection can provide significant and sustained pain relief for those suffering from chronic back and neck pain. It’s a preferred pain treatment option for several reasons, including:
- Localized delivery to the blood vessels and epidural space of the spinal cord
- Pain relief that lasts for weeks or months
- Opioid and drug-free pain-blocking capability
- Minimally invasive and therapeutic process
ESIs can help address the following conditions:
- Herniated Disks: Herniated disks occur when the disks that serve as the cushion between the vertebrae are pushed out or ‘herniated’ through a tear of the annulus fibrosus. The causes include aging, excessive weight, repetitive motions, or sudden strain. A herniated disk may also lead to nerve compression or irritation of the sciatic nerve (sciatica).
- “Slipped” Vertebrae: This happens when a vertebra slips out of place due to degenerative or genetic causes. A lumbar epidural injection can significantly help relieve the pain caused by this condition.
- Joint Cysts: These are round or oval lumps filled with jelly-like fluid that appear mostly in joints and tendons.
- Bone Spurs: Also called osteophytes, bone spurs are bony growths in the spine or joints usually caused by joint damage due to osteoporosis.
- Thickening Ligaments in the Spine: Also known as hypertrophy, this condition involves ligaments becoming less flexible due to aging, inflammation, injury, excess weight, or repetitive motion.
In addition to lumbar treatments, a cervical epidural steroid injection can be used to treat pain and inflammation in the neck and associated headaches or migraines. These therapeutic injections also aid in the repair of damaged tissues caused by chronic inflammation, offering effective, non-invasive relief.
Benefits of Epidural Steroid Injections
Epidural steroid injections offer numerous advantages for those suffering from chronic pain, making them an effective treatment option for pain management. These benefits include:
- Effective pain relief without the need for surgery
- Long-lasting relief from pain as compared to pain medications
- Reduced inflammation and nerve sensitivity
- Observing your pain’s response to the injection provides valuable information regarding the pain source. This helps in formulating your overall pain management plan
Things To Know Before Receiving Epidural Steroid Injections
Before receiving an epidural steroid injection, it is crucial to be well-informed about the procedure, especially if you suffer from chronic pain. Understanding its benefits, effects, and possible side effects will help ensure the treatment aligns with your needs.
To this end, you should inform your doctor about all your medications and supplements, such as blood thinners or blood pressure medications. You should also inform your doctor of any allergies or potential reactions to the medication being used. Finally, follow your doctor’s instructions regarding which medications to stop or continue to avoid a blood clot or blood vessel issues, and adhere to any guidelines about eating or drinking before the procedure.
Pre-Procedure Tips:
- Take a shower, but avoid lotions, creams, deodorants, perfume, or nail polish
- Bring your ID and arrange for someone to drive you home
Post-Procedure Tips:
- Rest and keep the spine straight by sleeping on your back or side
- Apply ice to the injection site if there’s residual soreness
- Follow your doctor’s aftercare instructions to ensure a smooth recovery
In addition to lumbar epidural steroid injections (a type of spinal nerve block), you may discuss other treatments like neurostimulation with your doctor to manage your pain. Don’t hesitate to ask questions. It’s essential to fully understand your treatment, know what to expect, and follow the post-treatment care plan.
At Bux Pain Management, our care plans are always patient-centered, ensuring you receive the best possible approach to your pain management.
How Do Epidural Steroid Injections Work?
Epidural steroid injections, a type of spinal nerve block, are preventive measures that help reduce inflammation and nerve irritation, making them an important part of your overall pain management plan.
Doctors may use a CT scan or X-ray images to guide where to precisely place the injection, ensuring the medication reaches the source of the pain. Once the needle is injected into the epidural space, the steroid coats the irritated nerve(s) that are causing your pain. This process works to reduce swelling and pressure on the nerves, allowing the affected nerve(s) time to heal. As the steroid reduces inflammation, it relieves pain and prevents further nerve irritation, providing relief over the course of several days or weeks.
It’s normal to feel some initial soreness or discomfort at the injection site. After the procedure, your doctor will advise you on the best position to sleep to ensure proper healing and comfort. Rest is essential, and you should follow your doctor’s aftercare instructions. Many patients experience significant pain relief within a few days, though some may take longer to notice the full effects.
Types Of Epidural Steroid Injections
At Bux Pain Management, we offer various types of epidural steroid injections, a steroid shot for the spine, including:
- Cervical Injections: Target nerve compression in the neck
- Thoracic and Lumbar Injections: Involve the chest and lower back
- Caudal Injections: Involve the sacrum and tailbone
- Interlaminar Injections: Target the epidural space between the laminae of two vertebrae
- Transforaminal Injections: Target the foramina where nerve roots exit
The target and pathway of the injection will be based on the patient’s specific pain source and condition. These injections are designed to reduce pain and inflammation, which can improve mobility and overall quality of life. While not drug-free, the mental and addictive side effects are much less risky compared to pain medications like opiates used for chronic pain.
After the procedure, there may be some minor side effects, such as soreness at the injection site. You’ll also need to arrange for someone to drive you home to ensure safety and comfort post-treatment.
What Happens During And After Epidural Steroid Injections?
During an epidural steroid injection, Dr. Bux and his team of medical professionals follow a step-by-step process to ensure precise medication delivery and provide thorough aftercare instructions to promote a smooth recovery and effective pain relief.
- WHAT TO EXPECT
1. Pre-Procedure Preparation
The first step involves preparing you for the procedure. Dr. Bux and his team will review your medical history and answer any questions you may have. If necessary, the doctor will order a CT scan.
2. Fluoroscopy Guidance
Dr. Bux uses an advanced X-ray technique called fluoroscopy to produce high-definition images in real-time. Fluoroscopy helps in visualizing your spine and precisely guiding a hollow needle into the epidural space.
3. Contrast Dye Injection
A contrast dye is injected to verify that the medication will flow correctly around the chosen nerves.
4. Medication Injection
You will be given epidural anesthesia to numb the area, and the corticosteroid medication will be injected. This can include different types of epidural injection therapy, such as a caudal epidural steroid injection, depending on the specific area of treatment.
5. Procedure Completion
Once the medication is administered, the needle is withdrawn, and the injection site is cleaned and bandaged.
- POST-PROCEDURE CARE
1. Immediate Rest
You should rest and relax after the procedure.
2. Ice Application
You can apply ice to the injection site to minimize any discomfort or soreness.
3. Pain Relief Monitoring
Most patients feel a reduction in pain in 1-2 hours once the local anesthetic wears off. You will typically feel more stable relief within 3-5 days, and the effects may provide long-term relief depending on your condition.
4. Aftercare Instructions
Dr. Bux and his team of medical professionals provide comprehensive aftercare instructions to help ensure a smooth recovery and remain available for any of your follow-up questions or concerns.
How Long Do Epidural Injections Last?
The longevity of relief provided by an epidural steroid injection can significantly vary from patient to patient, depending on their specific health condition and area of pain. However, unlike the short-term effects of pain medication, epidural cortisone shots offer more lasting relief that can significantly improve your quality of life.
When to have your next epidural steroid injection also depends on your specific condition. Patients with less severe inflammation may experience faster relief, lasting several months to a year. Those with more complex or severe conditions may require more frequent injections.
The pain’s location may also influence the duration of relief, as certain areas can respond differently to the injection. It’s important to monitor for any signs of nerve root damage, though this is a rare occurrence.
At Bux Pain Management, our team thoroughly evaluates each case to devise an individualized treatment plan, which could include additional injections for sustained pain relief. While non-pharmaceutical therapies are also available, injections are often an effective part of the overall pain management strategy.
Side Effects And Risk Of Epidural Steroid Injections
Due to the effectiveness of this minimally-invasive procedure, epidural steroid injections are widely used as a treatment for chronic back and neck pain. While generally considered safe, ESIs, like any medical procedure, carry a few potential side effects and risks.
At Bux Pain Management, we prioritize patient awareness and education regarding the potential risks of ESIs and adhere to rigorous safety protocols to minimize these risks.
- Potential Short-Term Side Effects
- Steroid flush: Patients might experience a “steroid flush,” characterized by flushing of the face and chest, warmth, and a temperature increase that may last for a few days.
- Trouble sleeping: Some individuals may struggle to fall asleep or stay asleep post-procedure.
- Anxiety: A feeling of anxiety or restlessness may occur temporarily.
- Menstrual Changes: Women may notice alterations in their menstrual cycle.
- Water Retention
- Potential Long-Term Side Effects
- Increased Pain: Though uncommon, some patients might feel an increase in pain for several days post-procedure.
- Bleeding: There’s a minimal risk of bleeding, particularly for individuals with bleeding disorders or those on anticoagulant medication
- Infection: Infections are rare but can occur, especially if a systemic or localized infection overlies the injection area.
- Paralysis: An extremely rare yet serious complication.
- Medication allergies: Uncommon allergic reactions to the medications used can occur.
- Nerve root damage: This is very rare and typically occurs only in extreme cases.
Managing The Side Effects Of Epidural Steroid Injections
Managing the side effects of a steroid injection for spinal pain involves a combination of proactive measures and attentive care. At Bux Pain Management, our team ensures patients are fully informed about potential side effects and how to address them.
- Mild discomfort at the injection site can be alleviated with ice packs and rest. You can also use a cushion to alleviate discomfort when sitting for extended periods.
- Sleeping issues and anxiety can be addressed by reducing caffeine intake, deep-breathing techniques, or meditation.
- For water retention, reduce salt intake and ensure you stay well-hydrated.
- Any unusual symptoms, such as prolonged numbness, increased pain, or allergic reactions to the medication, should be promptly reported to our medical team.
We provide detailed aftercare instructions, including activity limitations and signs to watch for, ensuring patients know how to care for themselves post-procedure. Our follow-up protocols and readily available support help manage any adverse reactions, ensuring a safe and effective recovery process.
Epidural steroid injections can be used to manage a variety of chronic pain conditions, including L4-L5 lumbar pain caused by issues such as herniated discs, spinal stenosis, or nerve compression in the lower back. These injections help reduce inflammation, providing long-lasting relief for conditions that impact different areas of the spine and other chronic pain sources.
How Are Epidural Steroid Injections Administered?
At Bux Pain Management, epidural steroid injections are administered by board-certified anesthesiologist and pain management expert Dr. Anjum Bux. To ensure patient comfort, a mild sedative is used during the procedure.
Utilizing fluoroscopy, Dr. Bux precisely guides a hollow needle into the epidural space of the spine. A contrast dye is then injected to confirm the accurate positioning of the needle near the targeted nerves. Following this verification, corticosteroid and local anesthetic medications are injected into the epidural space to reduce inflammation and alleviate pain caused by conditions such as sciatica. After the procedure, patients receive comprehensive aftercare instructions to support their recovery.
Rest assured, at Bux Pain Management, you will receive professional care and guidance throughout the process, helping to relieve your pain, minimize risks, and improve your quality of life, whether you’re seeking short-term relief or managing chronic conditions.
