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Epidural Steroid Injections: What You Need to Know
Doctors and patients alike hope to avoid back surgery as the solution for back pain. One minimally invasive treatment option is an epidural steroid injection to reduce back, neck, leg, or arm pain related to the spinal nerves. Medication is injected directly into the epidural space of the affected area with the purpose of relieving pain so the patient can begin physical therapy and return to normal activities.
What is it?
Both a corticosteroid medication and an anesthetic numbing agent make up an epidural steroid injection for the spine. The injection is administered into the area of the spine between the vertebra and the protective sac around the spinal cord and nerves. This injection reduces inflammation, although it does not reduce the size of something like a herniated disc itself. It flushes out proteins around the spinal nerves that cause inflammation. The resulting pain relief may last from days up to years. A physician who is experienced in providing epidural steroid injections, such as Dr. Fischer at NYU Langone Center For Musculoskeletal Care in NYC, can provide input about how effective the injection will likely be on each case. Successful injections improve spinal condition so that physical therapy can comfortably begin along the road to recovery.
Who needs an epidural steroid injection?
Patients experiencing back, neck, arm, or leg pain may be candidates for epidural steroid injections. Some common conditions that benefit from this are herniated discs, degenerative discs, sciatica, spinal stenosis, or spondylolisthesis. Dr. Fischer can accurately diagnose a patient’s condition and determine if this type of treatment is recommended.
What is the process?
Complete medical history and review of medications will be done prior to treatment. The injection is typically performed in an outpatient setting using X-ray fluoroscopy. It usually takes from 15 to 45 minutes and it is advised to have someone drive the patient home afterwards. Local anesthetic is used to numb the area so that the patient is comfortable throughout. Since the patient is awake, feedback can be given during the procedure. The fluoroscope allows Dr. Fischer to direct the medication into the ideal location. The procedure is usually not painful, with most patients just sensing slight pressure during the injection at the site.
What is recovery like?
After being monitored in recovery for a short period of time, most patients can usually go home and walk on their own. In rare occasions, some patients experience leg weakness or numbness at first. Most patients are able to return to work or other activities the next day. Any soreness in the injection area may be treated with ice and over-the-counter medication like Tylenol.
What are the long-term effects?
Patients who have minimal pain relief may be advised to have one to two more injections for optimum benefits. These are usually scheduled in 1 to 4 week intervals. The duration of benefits from epidural steroid injections varies, ranging from weeks to years depending upon the patient. Dr. Fischer recommends receiving injections in combination with a physical therapy or exercise program to achieve the best results.