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The Truth about Epidural Steroid Injections

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The Truth about Epidural Steroid Injections

  • Dr. Charla Fischer
  • Jan 01, 2019

One of the most common non-surgical treatments for back pain are epidural steroid injections. Used since the early 1950s, these injections can be a safe and effective way to give patients some pain relief while they strive for full recovery from their back problem. Epidural steroid injections are often used in combination with other treatments like physical therapy to provide patients with longer term results. NYC Spine Surgeon Dr. Fischer at NYU Langone Medical Center in New York City is experienced in offering patients injections along with a more comprehensive rehabilitation program.

Who can benefit from epidural steroid injections?
A number of common conditions that cause back pain may be treated with steroid injections. Some of these are:

  • Degenerative disc disease
  • Herniated disc
  • Spinal stenosis
  • Vertebral compression fractures
  • Annular tear
  • Cysts

How do the injections work?
Injected directly into the epidural space in the spine, an epidural steroid injection sends steroids right into the affected area. The injected solution usually contains a steroid such as cortisone, local anesthetic such as lidocaine, and saline. These agents act together to provide relief to the patient and flush out the area. The steroid is an anti-inflammatory agent, which is helpful in reducing swelling and associated pain. The quick-acting local anesthetic provides temporary pain relief, while the saline helps flush the area to dilute any agents that promote inflammation.

What are the benefits of injections?
One of the main benefits is the injection delivers medication directly to the source of pain. This differs from oral medications that disperse the medicine throughout the body in a less-focused manner. Also, the anti-inflammatory portion of the injection serves to additionally relieve pain.

Are injections only for the low back?
Dr. Fischer uses epidural steroid injections for more than just the low back, also called the lumbar region. The neck (cervical) and the mid-spine (thoracic) regions may benefit from steroid injections as well. This treatment is further used to treat radicular pain, or sciatica. This is pain that radiates along the sciatic nerve, which reaches down the buttocks, back of the leg, and even to the foot.

Can all patients benefit from epidural steroid injections?
It’s important to consult a qualified physician like Dr. Fischer at NYU Langone Medical Center to ensure that epidural steroid injections are right for you. Certain conditions like pregnancy, bleeding issues, or infection may eliminate a patient from being a good injection candidate.

Is this a permanent solution for my pain?
Typically, the answer is no. Epidural steroid injections provide relief ranging from a few weeks to one year. Instead of promising permanent relief, these injections are most helpful during an acute pain episode so that the patient can more comfortably perform a rehabilitative program of exercises and stretches. This gives patients a better chance at long-term relief. Dr. Fischer may advise patients that up to three epidural steroid injections are possible during the course of one year, so that permanent relief is more likely in the end.


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